The Federal False Claims Act, known as the “qui tam” statute, enables an individual to bring a case on behalf of the government. The lawsuit is filed in secret while the government investigates. If you’re right, and there is a recovery, you can expect a reward of 15% to 30% of the damages.
The Act also provides a remedy for retaliation: double lost wages and future pay.
KickbacksWe all think we know what a bribe looks like, but do we? Most corporations are too sophisticated to get caught handing over brown paper bags of cash.
Off Label Marketing FraudTo put it simply, a doctor can prescribe a drug for its “off label” effects (that is to say beneficial side effects) but a pharmaceutical company can’t market a drug for its off label effects.
“Upcoding” and billing for non-existent or unnecessary servicesAlong with flat-out bribery, this has got to be the most obvious of all false claims scenarios.
Patient Assistance Program FraudPatient Assistance Programs (“PAPs”) can play a vital role in making prescription drug copays affordable for Medicare patients (especially those relying on Part D insurance).
Nursing Home and Long-Term Healthcare FraudThe most basic requirement for reimbursement eligibility under Medicare and Medicaid is that the service provided must be reasonable and medically necessary.
SEC FraudOver the last few years, the United States has seen an unprecedented level of economic turmoil. Thanks, in part, to fraud in the financial sector.