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False Claims Act

Posted By: On behalf of J. Kevin Stockstill, Attorney At Law // On:

The False Claims Act (FCA) is a federal law meant to recover money that the federal government has paid out based on false claims. False claims are claims made falsely and knowingly to the government in order to receive or avoid the payment of money. For example, if a doctor submits a bill for an individual that the federal government insures for services he did not provide, he is violating the FCA.

This act is the most effective tool the government has to combat the waste, fraud, and abuse of federal spending. What's interesting is that you can violate the FCA, be completely unaware of it, and still be held accountable. It's important to point out the word knowingly here, as it is stated above in the FCA definition. Knowingly, in terms of law, means you know or should have known. Therefore, whether you are "deliberately ignorant" or have a "reckless disregard" for the truth, you are violating a federal law.

Louisiana Medical Assistant Programs Integrity Law

As a resident of Louisiana, it is important to know that the state has a law that directly mirrors the FCA to ensure that you are not violating a federal or state law. The Louisiana Medical Assistant Programs Integrity Law, known as MAPIL, states that a person may be liable if they knowingly submit false claims for goods, services, or supplies that are not medically necessary or are of a substandard quality or quantity.

Interestingly enough, Louisiana is one of nine areas in the U.S. that is considered to have a higher risk of medical fraud and FCA violations. Though the majority of Louisiana's violations involve no criminal intent, you can still be civilly or criminally charged. However, the government does not pursue investigations of fraud on a whim. Fraud investigations in violation of FCA or MAPIL are normally caused by qui tam lawsuits. Qui tam is the Latin term for "he who sues for king and himself." This is a lawsuit that is initiated by an individual against another individual or business they believe to be fraudulent.

Penalties: Civil vs. Criminal

If you are found civilly guilty, you will be required to pay triple the amount of government damages and up to $11,000 in fines per false claim. However, if you are found criminally guilty, you could be facing misdemeanor or felony charges with up to five years in prison. For a misdemeanor, you could face up to $100,000 per claim as an individual and $200,000 per claim as a business. For a felony, the fine for an individual is up to $250,000 per claim and $500,000 per claim as a business. In addition, you could be stripped of your professional license if you are criminally charged.

Have you found yourself accused of violating the False Claims Act? Call Kevin Stockstill today and schedule your initial consultation.

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