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False Claims Act and Qui Tam Defense

False Claims Act and Qui Tam Defense

Healthcare providers and companies conducting business with the government face increasing risks as part of everyday business. Among these risks are the threat of a case centered on the False Claims Act or Qui Tam. There has been a recent surge in whistleblower claims and lawsuits by regulators because of the possibility of treble damages and significant penalties.

The skilled attorneys of DM Cantor have the experienced you need on your side to convince the Federal Government to not intervene. This is often facilitated by finding weaknesses in whistleblower claims and attacking those through proactive case management directed toward an efficient and decisive close of the case. In False Claims Act cases, there are also frequently concurrent matters of criminal, civil and administrative proceedings. DM Cantor is highly skilled at coordinating and managing these matters toward the most effective resolution.

Healthcare Fraud and Regulation

Healthcare Fraud allegations can lead to criminal and parallel matters in both state and federal venues. The attorneys at DM Cantor are often called upon to aggressively defend clients and their companies against charges of Healthcare Fraud, in addition to False Claims Act prosecutions on Qui Tam cases.

Some matters under the umbrella of Healthcare Fraud crimes involve laws of self-referral, anti-kickback and fee-splitting. Compliance and self-reporting matters like these often include consultation of healthcare law experts for the most up-to-date and thorough advice. Healthcare Fraud can lead to criminal charges as part of parallel investigations and other proceedings under several state and federal offices, including:

  • Arizona Attorney General
  • United States Attorney’s Office
  • Department of Justice
  • Arizona Office of Inspector General
  • S. Office of Inspector General

Regardless of your position in an investigation or under accusations, you need to start protecting yourself and your career at the earliest possible juncture. For these matters you need aggressive and experienced defense, particularly to argue unjustified accusations before they lead to charges.  The White Collar defense lawyers of at DM Cantor are aggressive and thorough in their defense of clients accused of Healthcare Fraud.

Medicare Fraud

Fraud is defined by law as an intentional deception or misrepresentation made by someone who knows that the deception could lead to unauthorized benefit to himself or someone else. Fraud’s legal definition is provided through Federal Law per the United States Criminal Code; USC 42 CFR 455.2. Medicare fraud is no different than any other type of fraud, in that it is an attempt by Medicare providers or recipients of Medicare to benefit in some way that they should not.

Common types of Medicare fraud in Arizona – according to Arizona’s Medicaid Agency, AHCCCS – include:

  • Provider Fraud and Abuse
    • Falsification of Medicare claims and encounters
      • Claim alterations
      • Incorrect coding
      • Double billing
      • Submission of false data
    • Administrative and financial actions
      • Kickbacks
      • Falsified credentials
      • Fraudulent enrollments
      • Fraudulent recoupment
      • Fraudulent third-party liability reporting
    • Falsifying services
      • Billing for services or supplies not provided
      • Misrepresentation of services or supplies
      • Substitution of services
    • Member Fraud and Abuse
      • Eligibility Fraud
        • Resource misrepresentation
        • Residency misrepresentation
        • Household composition misrepresentation
        • Citizenship status falsification
        • Unreported income
        • Misrepresentation of medical condition
        • Failure to report third party liability

Medicare Fraud Penalties

Penalties for Medicare Fraud are tough. These include both Arizona and federal Medicare Fraud violation penalties.

Fines for Medicare Fraud include:

  • Federal fines
    • $250,000 for individuals
    • $500,000 for corporations
  • State fines of Arizona
    • $100,000 for individuals
    • $200,000 for corporations
  • Other penalties

Being investigated or arrested for Medicare Fraud is no small matter. As soon as you are aware that your Medicare activities are under question and scrutiny, it is essential that you secure the experienced and aggressive legal counsel of DM Cantor. The DM Cantor White Collar Defense team includes lawyers that are highly familiar with Medicare laws, fraud and even the prosecution’s procedures that will be used in your case.

For this type of legal matter, you need legal advice and representation that is top-notch with experience in both state and federal courts. Further, you need aggressive criminal defense that will fight your charges for you as you would for yourself. Whether your alleged Medicare Fraud occurred in Phoenix, Scottsdale, Tucson, or any other community of Arizona on the U.S., having early legal support can pave your pathway through the judicial process and lead to an acquittal or dismissal. Many cases can be resolved without charges even being filed.

The Legal Defense You Need for Healthcare Medicare Fraud Allegations in Arizona

If you are under investigation or have been charged with Medicare Fraud, you need immediate legal representation. The lawyers of DM Cantor are aggressive and thorough in their defense of clients accused of Healthcare and Medicare Fraud.

With the highest possible rating by Martindale Hubbell® as an AV ® rated law firm, DM Cantor has the legal skill you need on your side. The firm is also listed in the Criminal Law Section of the Bar Register of Preeminent Lawyers®. Schedule your appointment today by calling 602-307-0808 or Contact Us for a Free Case Consultation.

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