Griffin Durham Tanner & Clarkson is known for its expertise both pursuing and defending False Claims Act (“FCA”) investigations. Griffin Durham attorneys have prosecuted and defended some of the FCA cases in the Southeast, totaling in excess of $100 million in settlements and judgments. Our experience is broad: we have represented the United States, whistleblowers, companies, and individuals in FCA cases where allegations involve fraud against the government. Using our unique background, we are prepared to represent anyone involved in an FCA investigation.
Types of Cases Prosecuted Under the False Claims Act
Every year, the U.S. government loses hundreds of billions of dollars to fraud. Created during the Civil War, the United States False Claims Act (FCA) remains the powerful tool it was designed to be — a statute under which the federal government can reclaim funds lost to contractors (i.e. those who provide the government with goods and services). Georgia and 30 other states have their own False Claims Acts, modeled after the federal law.
With the DOJ, government agencies investigate individuals, companies, groups, and organizations in the areas of:
- Health care
- Military procurement
- Department of Education loans
- Small Business Administration Relief Programs
- Small Business Administration Set-Aside Programs
- Federally-subsidized mortgages
- Customs and duties
- Federal loan programs
How the FCA Works
Under the FCA, the government and/or whistleblowers can file lawsuits against those they accuse of defrauding the federal or state government. By law, any whistleblower suit will first be filed “under seal” — or hidden from the public. By keeping whistleblowers and their allegations anonymous at the start, the DOJ can then begin to investigate with the alleged violator becoming aware of the whistleblower or government scrutiny.
The DOJ pursues companies and individuals who it suspects may have violated the FCA. With assistance from agencies, DOJ will use a wide range of tools to compel those under investigation and witnesses to provide information. Common tools in FCA investigations include civil investigative demands (“CIDs”), administrative subpoenas, and inspection warrants, all of which can be used separately or in the same case to gather information. When investigators approach targets, subjects, or witnesses, they will have likely already used these tools to obtain documents, medical records, emails, text messages, and sometimes even recorded conversations. Frequently, an investigation becomes “overt” and people will become aware a FCA investigation exists.
After an investigation is complete, the government may decline to pursue the investigation further. The government may also decide to try to resolve the matter with a potential defendant without litigation. If a resolution cannot be reached, the government can pursue litigation or a whistleblower can pursue litigation on behalf of the government.
If the government or the whistleblower prevails at trial, the damages paid by the defendant can be enormous — three times the loss plus additional penalties ranging upward from tens of thousands of dollars for each violation. A whistleblower can obtain up to 30% of the total amount recovered by the government as part of a settlement or judgment. Each year, millions of dollars are paid to whistleblowers around the country for alerting the government to fraudulent activities.
False Claims Act Violations in Health Care
In our experience, most FCA investigations occur in the field of health care. Common issues in FCA investigations include:
- Providers who misrepresent services billed to Medicare or Medicaid but not actually performed
- Durable medical equipment false claims
- Pharmacy and Medicare Part D false claims
- Providers who inflate the type of services performed
- Health care providers that bill as if procedures were performed by skilled professionals when in fact they were administered by less-skilled assistants
- Drug company reps, marketers, or other providers who offer incentives and kickbacks to doctors to obtain patients and referrals
- Violations of the “Stark Law” and prohibited financial relationships between medical providers
- Medical providers that charge for medically unnecessary services
Other Violations Covered by the False Claims Act
Not all FCA violations occur in health care. Our attorneys are also adept at handling cases in which you have been accused of:
- Offering business kickbacks or rewards to government employees to get contracts
- Billing the military for unused materials or unperformed labor
- Providing false credentials or other information when applying for a government grant
- Using lower quality materials than contracted and billed for by a government agency
- Giving false information to the Department of Veteran Affairs
- Claiming pay for unworked hours as a government employee
- Taking, or improperly purchasing, property that belongs to the government
- Retaliating against a whistleblower by demotion, wrongful termination, blacklisting, etc.
Contact Our Experienced False Claims Act Attorney
The attorneys at Griffin Durham Tanner & Clarkson have experience from every angle of FCA case: as federal prosecutors, representing whistleblowers in meritorious cases; and defending those caught up in meritless investigations. Contact us now for a consultation.