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The False Claims Act was designed many years ago to prevent fraud and abuse against the government. In modern times, the act specifically relates to claims filed by medical providers that violate Medicaid and Medicare guidelines. These cases are hybrid in nature and can have a civil and criminal impact. Since it’s important for medical providers to maintain these contracts with these governmental insurers, it’s important that they’re treated seriously. This article will address matters under the False Claims Act and how they can be handled by a highly skilled and competent federal courts experienced attorney.

How False Claims Act Violations are Reported

There are many ways that charges can arise that place you at the target of a False Claims Act case. One of the most common ways is through fraud monitoring through federal insurers or an outside auditing agency. A recent spike in claims or significant changes in claims filings can set off a red flag to auditors. Another common way is through claims that are brought by a former employee or another “whistleblower.” These cases are often initiated out of spite or some perceived financial gain to the reporting party. Regardless of who initiates the claim, there are important steps to take if you’re on the receiving end.

Typically, if you’re under investigation you’ll be notified through the government, an auditor, or another third-party such as an insurance carrier. It’s important that you have all your documentation and records handy and ready to be inspected prior to the investigation. Once you’re aware that an investigation has been initiated, you’ll want to contact a healthcare defense attorney at once. They’ll be able to review the claim and help you respond appropriately. If you’re beyond this point, you’ll want to have your attorney involved in the investigation. They’ll be able to determine if the investigation is warranted and the effects it could have on your practice. It’s important that if you’re aware of the reporting party, you don’t have any contact with them regarding the matter.

Developing a Solid False Claims Act Defense Strategy

If the investigation yields unfavorable results, an attorney can prepare a winning defense on your behalf. Often, attorneys find that the extent of the damage from false claims resulted in negligence rather than blatant fraud and abuse. In this scenario, it’s much easier to justify that severe penalties aren’t in order. These cases can also come from errors that are through no fault of your own or your practice. The attorney will be able to point out the errors and may be able to have the case dismissed quickly.

The Pitfalls of Pro Se Litigation

Representing yourself in court is never a good idea. It’s especially advisable in the complex arena of healthcare law that has many moving parts. Our courts are designed for cases to be argued by attorneys that are educated in law and court procedure. The legal system is unsympathetic to those that simply don’t feel that they need to hire an attorney. The effects in a federal-level case can be devastating if not handled correctly the first time. You’ll find professional representation to be a wise and worthwhile investment.

Risking your career and important contracts aren’t worth the effects they’ll have on your business and personal life. Getting in touch with a qualified attorney that routinely handles False Claims Act cases in federal court should be a top priority. We’ll be happy to provide you with valuable feedback on how we’ll be able to handle your case. Call us to schedule an appointment for your case review, today!

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