Qui Tam - Who Commits Fraud

	President Barack Obama has signed into law the Fraud Enforcement Recovery Act (FERA), strengthening your ability to go after fraudulent contractors. Read More
	NJ becomes the 22nd state to enact a false claims act. Read More
	Whistleblowers are responsible for nearly 78% of recoveries made by the U.S. Government in 2008. Read More
	The U.S. Government has recovered over $21 Billion since 1986, $2.2 of that recovery went to whistleblowers. Read More
	The IRS increases the amount of the award a whistleblower can receive. Read More

•		Aerospace Fraud
•		Construction Fraud
•		Defense Contract Fraud
•		Grant Fraud
•		Health Care Fraud
•		Medicaid Fraud
•		Medicare Fraud
•		Nursing Home Fraud
•		Oil Lease Fraud
•		Pharmaceutical Fraud
•		Procurement Fraud
•		US Postal Service Fraud

Just like those who report fraud, those who commit fraud against the government come from all walks of life… blue collar and white collar; office workers, accountants, executives, medical professionals, corporate executives and more. And, while most of the early successes in Qui Tam actions have been litigated against defense contractors, more and more actions are being filed on behalf of other Federal agencies including the Departments of Health and Human Services, Agriculture, Transportation, Energy and Education, as well as NASA and the EPA to name a few. These cases may involve a number of different violations such as labor and environmental statutes. Of the most recent fraud actions filed, many have been against hospitals, pharmaceutical manufacturers, physicians, large cities, counties and smaller local municipalities.

DOCUMENTATION IS KEY
It is important to describe and help your attorneys understand as many of the details about the fraudulent act as possible—the actual false claims, the people involved, the regulations that were violated and the operation of the claim’s process—both at the company and at the government level. Evidence and documents such as journals, memos and notes are very helpful. Remember, unless someone knowingly made a false statement, submission, or certification to the government, there will not be a basis to file suit under the False Claims Act.

METHODS USED TO DEFRAUD THE GOVERNMENT
Unscrupulous individuals and corporations have devised many inventive ways to commit fraud against the government. These range from simple over-billing practices to complex corporate schemes that impose a cost to the taxpayer of hundreds of billions of dollars each year. They include…

	“Phantom Billing” for tests that are not performed, or products not delivered.
	Billing for inappropriate or unnecessary procedures.
	Overcharging for items purchased for much less.
	Charging for equipment or supplies that were never ordered.
	Billing for new equipment but providing used equipment.
	Billing for expensive equipment but providing low-cost equipment.
	“Code Jamming” by labs that insert fake diagnosis codes to get Medicare/Medicaid coverage.
	Submitting multiple bills to obtain a higher reimbursement for tests, products or services.
	“Double Billing” by charging more than once for the same service.
	“Up Coding” and billing for complex services when only simple services were performed.
	Billing for brand-named drugs when generic drugs were provided.
	Expensing “Phantom Employees” or hours worked that do not exist.
	Submitting “Improper Cost Reports” to obtain higher reimbursements.