About the False Claims Act

The Federal and Illinois False Claims Act

The Federal False Claims Act, 31 U.S.C. §3729, et seq., and Illinois False Claims Act, 740 ILCS 175/1, et seq., permit a private person, the whistleblower, relator, or qui tam plaintiff, to sue on behalf of the government. These False Claims Acts allow a person to sue a company or person who has defrauded the government by submitting or causing to be submitted false or fraudulent claims. The government is the real party in interest and is a Plaintiff in the case, although it is in a sense being represented by the attorney for the relator. A “claim” is defined as a demand for payment.

“Claim” is interpreted broadly to include false statements made in order to get a false or fraudulent claim paid or approved, where the actual claim itself may not be false, or even false certifications such as when a contractor certifies or states under oath that it is in compliance with some statute or has not violated a statute like the anti-kickback statute.

If the False Claims Act lawsuit is successful and results in a judgment or settlement, the whistleblower is entitled to an award that is based on a percentage of the amount recovered for the government. The percentage is between 15% and 25% if the government intervenes and takes over the action and between 25% and 30% if the government declines to intervene. Even though it may appear that having the government decline intervention is in the whistleblower’s interest, statistics show that it is not. Almost all of the recoveries under the Federal False Claims Act have come from cases in which the government has intervened. There are no statistics for recoveries made just under the Illinois False Claims Act.

Over the past years, Medicaid fraud and Medicare fraud have become two of the top areas of False Claims Act litigation. Originally, the False Claims Act was passed into law to target defense contractors who were defrauding the Union Army during the Civil War. These forms of government fraud cost taxpayers and the government billions of dollars each year. The most common Medicaid and Medicare fraud schemes include:

• billing for services or products/devices not provided
• up coding which is billing at a higher reimbursement rate, such as submitting a false claim for a more complicated procedure than performed
• submitting a false certification that certain requirements were met, such as not violating the anti-kickback statue or the prohibition against self-referrals known as the Stark Act.

Michael C. Rosenblat was the lead prosecuting attorney for the Illinois Medicaid Fraud Control Unit (MFCU) and has significant experience representing whistleblowers who have evidence that a company or person has submitted false claims to Medicare, Medicaid or other government funded programs. These programs include military programs, public works projects, grant programs dealing with education or medical research, or agricultural subsidies. Mr. Rosenblat has successfully represented whistleblowers in both declined and intervened cases.

If you are in search of legal representation concerning a potential false claims act case, or would like more information about our services, contact the Rosenblat Law Firm today since there are many limitations on filing a false claims act case including first to file and the public disclosure bar. To set up an initial consultation contact Michael C. Rosenblat at 847-480-2390 or send an email to mike@www.rosenblatlaw.com.