Medicare Fraud Qui Tam & Whistleblower Actions

Medicare Fraud and False Claims Qui Tam Actions

A Medicare Qui Tam action is when an individual sues or prosecutes for Medicare fraud in the name of the Government and shares in the proceeds of any successful litigation or settlement – sometimes as much as 30%.  The expansion of the healthcare sector, and consequently health care fraud, has caused an increase of False Claims Act cases against health care companies, physicians, and other health professionals.  If you believe you are facing a Medicare Qui Tam action, or if you have information that a health professional or healthcare company is committing health care fraud, you should contact the Qui Tam Medicare fraud attorneys at the Chapman Law Group today.  We are an experienced health law firm. We have significant experience in prosecuting and defending Medicare Qui Tam actions related to health care fraud.

Who Can Bring a Medicare Fraud Qui Tam Actions

Any private individual with knowledge of Medicare fraud or a false claim made to the Government, may bring a Medicare Qui Tam action.  A person bringing a Qui Tam action is called a “Relator.” The Relator stands in the shoes of the Federal Government, when bringing a Medicare fraud Qui Tam action.  The Government may elect to intervene in the case.  If the Government does not wish to intervene, it may do so at a later date.  A Relator may not bring a false claims act action based on public information or information from official proceedings, unless the Relator is the original source of the information.  Furthermore, a Relator may not bring an action where a private individual has raised a similar Medicare fraud Qui Tam action.

Typical Medicare fraud Qui Tam actions involve:

  • Fraudulently billing Medicare, Medicaid, Tricare, etc.
  • Overbilling, upcoding, billing for procedures not provided.
  • Violations of Stark and the Anti-Kickback Statute by physicians, pharmacies, laboratories, etc.
  • Improper registry agreements.
  • Recovery under the Medicare Incentive Reward Program.

Government Intervention in Medicare Qui Tam Actions

A Medicare fraud Qui Tam action is filed under seal for approximately sixty (60) days. The Relator serves the Department of Justice Civil Division (“DOJ”) with a copy of the Complaint.  The DOJ has sixty (60) days to investigate the case and determine if it wishes to intervene.  Routinely, the DOJ will notify the Court that it makes no decision on intervention, reserving the right to intervene later.  If the Government does not intervene, a Relator can earn up to 30% of the judgment or settlement.  If the Government chooses to intervene, the Relator will earn a lower percentage of the recovery.

Our Medicare Fraud Attorneys

Medicare fraud Qui Tam Whistleblower cases are often very complex. They require the skill of an attorney who frequently deals with the complex Federal laws pertaining to the False Claims Act. For over 25 years we have represented thousands of clients in Federal court with cases related to health care and therefore have significant experience handling Federal health care cases. If you feel that you have a Medicare fraud Whistleblower Claim or have been named in a Medicare Qui Tam action, contact the Medicare fraud attorneys at Chapman Law Group immediately.  Our Medicare fraud attorneys have a significant amount of experience in dealing with Medicare Qui Tam / Medicare fraud Whistleblower actions related to health care.

Comparison of Health Care Fraud Statutes and Penalties


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