The False Claims Act

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Recommended: Fraud and Abuse in the U.S. Health Care System

Chapter
Health Care Fraud Anyone who discovers questionable Medicare and Medicaid fraudulent practices can file a confidential legal claim under the False Claims Act. –Author
Introduction
W hite collar crime and public corruption have a direct impact on the American taxpayer; it is a myth that such crimes are victimless. The United States is struggling to create a health care system that meets the public’s ever changing needs at a reasonable cost. In this chapter, we illustrate the magnitude of health care fraud and how it impacts the taxpayer and eldercare. You are encouraged to report suspected cases. Reading these cases, you will notice how well individuals are rewarded when they stand up against outlandish creed.
Department of Justice …show more content…

It resolved Abbott’s civil liability under the False Claims Act for paying kickbacks to nursing home pharmacies.
Using the False Claims Act, the DOJ consolidated whistleblower lawsuits and filed its complaint against Omnicare. Whistleblower provisions of the False Claims Act allow private parties to sue for fraud on behalf of the United States and share in any recovery. The Ohio pharmacists that instigated the lawsuit received close to $17 million. Doctors who received the kickbacks were allowed to continue practicing medicine.
These cases are captioned United States ex rel. Spetter v. Abbott Labs., et al., Case No. 10-cv-00006 (W.D. Va.) and United States ex rel. McCoyd v. Abbott Labs., et al., Case No. 07-cv-00081 (W.D. Va.). The claims asserted in the government’s complaint are only allegations and there has been no determination of …show more content…

Becoming a “whistleblower” in what is legally known as a “qui tam” lawsuit, a private individual may collect up to 30 percent of the amount recovered, depending on how the case is prosecuted. “Qui tam” is an abbreviated Latin phrase “qui tam pro domino rege quam pro se ipso in hac parte sequitur,” which means “Who sues on behalf of the King as well as for himself.” You may report potential instances of waste, fraud, or abuse related to HHS’s programs on their hotline Website. The department will appoint a Whistleblower Ombudsman. At this site you can review individual state false claims acts. Click this link and view the department’s most wanted health care fraud

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