The False Claims Act (FCA), enacted in 1863, is a federal law that allows the government to combat fraud by imposing liability on individuals and companies who knowingly submit false claims for government funds. Under the FCA, violators must pay up to three times the government’s damages plus additional penalties. The Act also includes a “qui tam” provision, which allows private citizens to file lawsuits on behalf of the government and share in any recovered damages. This law has been instrumental in recovering billions of dollars lost to fraud and deterring fraudulent activities against the government.
If you work in the health care industry and knowingly submit a false claim for services funded by the U.S. government, like Medicaid or Medicare, it can be an extremely serious problem. Owners or employees could face severe penalties, including criminal charges, and the penalties would be hard, if not impossible, for the business to recover from.
3 steps to protect your business
Taking the proper steps can help owners and managers address the situation effectively to maintain the business’s viability. Here are three steps to start your defense:
1. Gather information
Start by collecting all relevant information about the accusation. This includes understanding the specific claims, who is making them and any evidence the accuser provided. Review your business records, marketing materials and communications to see if there is any basis for the accusation. This will all help you understand the scope of the issue and prepare for the next steps.
2. Consult legal counsel
It’s crucial to seek knowledgeable legal advice as soon as possible. A lawyer who handles false claims issues can help you understand your rights and obligations. They can also guide you in responding to the accusation and taking steps to protect your business. Legal counsel can help you navigate the situation’s complexities and avoid making any statements or actions that could worsen the situation.
3. Respond appropriately
Based on the advice of your legal counsel, prepare a response to the accusation. It might involve issuing a public statement, contacting the accuser directly or taking corrective actions if there is any merit to the claims. It’s essential to address the issue promptly and professionally to maintain your business’s reputation and credibility. Be transparent and honest in your communications and show that you take the accusation seriously.
The next steps
After these initial steps, you’ll be better prepared to develop a long-term response strategy. It is wise to act professionally and avoid making statements that could further complicate the situation without first discussing matters with your legal counsel.
Attorney John Rivas is responsible for this communication.