The federal False Claims Act allows individuals, called relators, to bring lawsuits -- qui tam claims -- on behalf of the government, and the relators may collect a portion of any amount of money the government recovers. Since the mid-1980s, the United States government has recovered more than $15 billion through qui tam claims, and that figure continues to rise.
Recently, CareAll Management, a Tennessee-based home healthcare provider, agreed to pay more than $25 million to resolve allegations that CareAll and its affiliates violated the False Claims Act. This latest settlement marks the second time in the last two years that CareAll has paid for allegedly submitting false claims.
Specifically, in this latest case, CareAll was accused of submitting false and exaggerated billings to Medicaid and Medicare over the course of about seven years. According to the qui tam claim, the healthcare provider overstated patients' conditions and billed for unnecessary services.
The relator who blew the whistle on CareAll is expected to receive about $3.9 million.
Two years ago, CareAll paid about $9.38 million to settle allegations that it submitted false reports to Medicare.
To help prevent future fraud, the more recent settlement also requires CareAll to meet the terms of a corporate integrity agreement.
Federal False Claims Act lawsuits are filed either with the Department of Justice or the U.S. Attorney General's office, and relators generally need lawyers to work as adjuncts to the federal government. State laws may also provide a way for whistleblowers to bring a qui tam claim. If you have questions about the False Claims Act or similar state laws, then a qui tam attorney can provide answers.
Source: Corporate Crime Reporter, "CareAll Management to Pay $25 Million to Settle False Claims Act Charge," Nov. 12, 2014