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What Are The Penalties Under The False Claims Act?

false claims act
Dr. Nick Oberheiden, Esq.
www.federal-lawyer.com
(214) 692-2171
Including Weekends

The federal False Claims Act is one of the most ubiquitous and most frequently utilized federal healthcare enforcement statutes. At its core, the statute allows the U.S. government to investigate and prosecute individuals and businesses that have entered into a government service contract. Agreeing to service Medicare and other federally funded patients means subjecting oneself to the provisions of the False Claims Act. Every false claim submitted, even if completely unintentional, falls within the purview of the statute and authorizes agents and prosecutors to begin their case examination.

Most providers will first find out that something is possibly wrong when they are contacted by federal agents or when the business or practice receives a subpoena. These subpoenas, typically issued by the Office of Inspector General within the Department of Health and Human Services, ask for documents, records, and communications in the possession of the targeted business that the government believes to be helpful for resolving the matter. Once such a subpoena is served, the business owners should immediately contact an attorney because, as will be seen now, the False Claims Act is a so-called hybrid statute imposing both civil fines as well as criminal prosecution, and the wrong defense approach may turn a civil False Claims Act audit into a criminal matter.

Targets of False Claims Act Investigations

False Claims Act investigations in the healthcare sector are investigated by an amalgam of federal agencies and federal law enforcement offices. Depending on the particular branch within the healthcare industry and the size of the investigation, False Claims Act audits are most commonly orchestrated by the local U.S. Attorney’s Office, the Department of Health and Human Services, and the Office of Inspector General. In Tricare fraud cases, False Claims Act investigations are led by the Department of Defense and the FBI. Business owners and healthcare executives of the following sectors are currently under particular governmental scrutiny.

  • Pharmacies & Compound Pharmacies
  • Toxicology Laboratories
  • DNA Testing Facilities
  • Healthcare Executives
  • Prescribing Physicians
  • Telemedicine Consultants
  • Healthcare Marketers

If you have received an audit request, an OIG subpoena, a letter from the U.S. Attorney’s Office, a Grand Jury Subpoena, a target letter from the Department of Justice, or similar correspondence you should not wait but contact an attorney right away to avoid possible criminal prosecution. The former healthcare prosecutors and experienced healthcare fraud defense counsel of Oberheiden, P.C. are standing by to speak with you directly—free and confidential.

Put our highly experienced team on your side

Dr. Nick Oberheiden
Dr. Nick Oberheiden

Attorney-at-Law & Founder

Amanda Marshall
Amanda Marshall

Former U.S. Attorney

Local Counsel

Lynette S. Byrd
Lynette S. Byrd

Former Federal Prosecutor

Partner

Aaron L. Wiley
Aaron L. Wiley

Former Federal Prosecutor

Local Counsel

Subodh Chandra
Subodh Chandra

Former Federal Prosecutor

Local Counsel

Elizabeth K. Stepp
Elizabeth K. Stepp

Partner

Roger Bach
Roger Bach
(Non-Lawyer)

Former Special Agent, OIG

Dennis A. Wichern
Dennis A. Wichern
(Non-Lawyer)

Former Special Agent-in-Charge

Chris Quick
Chris Quick
(Non-Lawyer)

Former Special Agent, FBI

Kevin M. Sheridan
Kevin M. Sheridan
(Non-Lawyer)

Retired Supervisory Special Agent, FBI

Ray Yuen
Ray Yuen
(Non-Lawyer)

Former Supervisory Special Agent, FBI

Gamal Abdel-Hafiz
Gamal Abdel-Hafiz
(Non-Lawyer)

Former Supervisory Special Agent, FBI

Civil & Criminal Penalties

Civil Penalties:

  • The Federal False Claims Act at 31 U.S. 3729 permits the government to demand civil fines of up to $ 11,000 per false claim in addition to recoupment requests, treble damages, fees payable to the attorneys of the U.S. government, and exclusion from federal healthcare programs.
  • Monetary penalties are typically imposed on companies, but in rare cases can extend to responsible individuals (CEO, CFO, COO, board members etc.).
  • It is important to note that civil liability under the False Claims Act does not require a specific intent to violate the law; in fact, the government does not even need to prove actual knowledge of the wrongfulness of the transaction.

Criminal Penalties:

  • Under the criminal provision of the False Claims Act (18 U.S.C. § 287), individuals found guilty of knowingly presenting a false claim for payment to any government agency or official may be sentenced to a maximum prison sentence of 5 years in additional to criminal fines.

Oberheiden, P.C.

Oberheiden, P.C.— Healthcare Fraud Defense —is headed by Dr. Nick Oberheiden. Dr. Oberheiden is the managing principal of Oberheiden, P.C.. The following are recent case outcomes that our attorneys achieved for clients spread across the United States.

  • False Claims Act Investigation (Physician)
    Result: No civil liability, no criminal charges.
  • False Claims Act Investigation (Physician)
    Result: No civil liability, no criminal charges.
  • False Claims Act Investigation (Laboratory)
    Result: No civil liability, no criminal charges.
  • False Claims Act Investigation (Laboratory)
    Result: No civil liability, no criminal charges.
  • False Claims Act Investigation (Laboratory)
    Result: No civil liability, no criminal charges.
  • False Claims Act Investigation (Service Company)
    Result: No civil liability, no criminal charges.
  • Stark Law Investigation (Physician)
    Result: No liability, case dismissed.
  • Stark Law Investigation (Physician)
    Result: No liability, case dismissed.
    • Stark Law Investigation (MSO)
      Result: No liability, case dismissed.

Free Consultation

If your practice is subject to a False Claims Act audit or if your business was subpoenaed by the government, you should contact the experienced attorneys at Oberheiden, P.C. for a free and confidential consultation. Call us, including on weekends.

This information has been prepared for informational purposes only and does not constitute legal advice. This information may constitute attorney advertising in some jurisdictions. Reading of this information does not create an attorney-client relationship. Prior results do not guarantee similar future outcomes. Oberheiden, P.C. is a Texas LLP with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

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