Fraud Against the Government

AbbVie Humira

University Womens Clinic

On September 18, 2018, Lieff Cabraser and California Insurance Commissioner Dave Jones sued AbbVie, Inc. for violations of the Insurance Frauds Prevention Act (“IFPA”) by providing kickbacks to healthcare providers throughout California relating to sale of the immunosuppressive drug Humira.

After the defendants sought removal to federal court, in July 2019 Judge James Donato of the U.S. District Court for the Northern District of California issued an order remanding the case back to California Superior Court, noting that plaintiffs brought suit against AbbVie only for its conduct in California, that of pursuing its two illicit schemes to “pump up” the sales of Humira in California.

The lawsuit, filed in California Superior Court in Alameda, California, alleges that AbbVie engaged in a far-reaching scheme to maximize profits and the number of prescriptions of Humira via “classic” kickbacks—including cash, meals, drinks, gifts, trips, and patient referrals—as well as more sophisticated kickbacks, including professional services to physicians to induce and reward Humira prescriptions. These kickbacks saved time and money for doctors and their staff.

The Complaint further alleges that AbbVie deployed so-called “Ambassadors” directly into patients’ homes, ostensibly to provide a helping hand, but in fact—and cynically—to provide valuable services to benefit health care providers, ensure prescriptions were filled, and deflect patient concerns. Unfortunately, AbbVie directed its Ambassadors to avoid patient questions about risks for the dangerous drug.

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Education Fraud

Fraud Against the Government

Fraud Against the Government: Cases in Higher Education

Fraud against the government in higher education is rampant. Successful lawsuits under the False Claims Act have led to significant recoveries for students and for the government. Lieff Cabraser obtained a record False Claim settlement against the University of Phoenix in a case that charged that Phoenix had violated the Higher Education Act by providing improper incentive pay to its recruiters. High student loan default rates not only result in wasted federal funds, but the students who receive these loans and then default are burdened for years with tremendous debt without the benefit of a college degree.

In addition to cases against schools that pay recruiters for enrolling students, other government fraud lawsuits in higher education have included actions against schools that encourage students to falsify academic credentials to get federal funding. Schools have been sued for practices geared to arbitrarily increasing student fees, including penalty fees for missed classes and schedules designed to make course completion so difficult that many students are forced to retake and re-pay for credits. Still other schools have faced lawsuits for inflating course costs and for wildly exaggerating graduate placement rates and thus degree value.

False Claims Act Attorneys

Lieff Cabraser represents individuals exposing fraud against the government in a wide range of federal False Claims Act and other government fraud cases. We have the resources, experience, and skill to appropriately investigate even the largest and most complex matters and take them all the way through trial. Learn more about our work in helping individuals stop fraud that cheats the government and obtain significant recoveries.

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Please use the form below to contact a False Claims Act lawyer at Lieff Cabraser regarding your fraud-on-the-government lawsuit or for answers to your questions on qui tam law. Our False Claims attorneys will promptly and confidentially review your inquiry without charge or obligation.


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California False Claims Act Lawyers

Lieff Cabraser San Francisco

From our office in San Francisco, Lieff Cabraser’s fraud-on-the-government attorneys represent clients throughout California and the nation. We have successfully represented clients or are representing clients from the San Francisco Bay Area, Silicon Valley, and Los Angeles and Southern California in cases exposing fraud committed against the government by major corporations across multiple industries.

False Claims Act Lawyers

We represent individuals who have uncovered fraud committed against the government in a wide range of federal and state False Claims Act cases. We have the resources, experience, and skill to appropriately investigate even the largest and most complex matters and take them all the way through trial. Learn more about our work in helping individuals expose fraud and obtain meaningful recoveries.

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Please use the form below to contact a fraud-on-the-government lawyer at Lieff Cabraser regarding your false claims act lawsuit. Our False Claims Act lawyers will review your claim without fee or obligation, and Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.


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Nashville Tennessee False Claims Act Lawyers

Nashville Tennessee at night

From our office in Nashville, Lieff Cabraser represents clients from Tennessee, the South, and Midwest in fraud-on-the-government cases brought under the federal False Claims Act and similar state laws. We have successfully represented clients or are representing clients reporting fraud committed against the government by major corporations across multiple industries.

In June 2014, Mark Chalos, a partner at Lieff Cabraser based in our Nashville office, gave a presentation to a group of Tennessee lawyers summarizing the False Claims Act and discussing the latest developments in fraud-on-the-government law. Read a copy of Mark’s presentation on False Claims Act law.

Focus on Healthcare Fraud

Kickbacks paid to physicians to prescribe certain drugs or treatments, false statements made to obtain payment for unnecessary tests and procedures, double billing for medical charges, “upcoding” charges to be paid for more than the services provided, and fraud by hospice providers and nursing homes are some the ways Medicare fraud occurs. These types of fraud trigger violations of the False Claims Act as it prohibits persons and companies from submitting false claims for payment from the government.

Numerous lawsuits charging Medicare fraud have been filed in federal court in Nashville due to the significant number of companies in the health care field located in Nashville and elsewhere in Tennessee. More than 250 health care companies have operations in Nashville and work on a multi-state, national or international basis, with more than 300 local professional service firms (e.g., accounting, architecture, banking, legal) providing expertise in the health care industry. Nashville’s health care industry generates more than $70 billion in revenue.

False Claims Act Lawyers

We represent individuals in a wide range of federal and state False Claims Act cases. We have the resources, experience, and skill to appropriately investigate even the largest and most complex matters and take them all the way through trial. Learn more about our work in helping individuals expose fraud against the government and obtain meaningful recoveries.

Contact Lieff Cabraser

Please call Mark Chalos at 1 866 313-1973 to discuss your fraud-on-the-government case. Or use the form below to contact Mark for a prompt, free, and confidential review of your inquiry without any charge or obligation.

Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.


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New York False Claims Act Lawyers

Lieff Cabraser New York

From our office in New York City, Lieff Cabraser’s fraud-against-the-government attorneys represent clients throughout New York and the nation. We have successfully represented or are representing clients from the New York metropolitan area, New York state, and the larger tri-state area and the East in cases where fraud has been committed against the government by major corporations across multiple industries.

False Claims Act Lawyers

We represent individuals reporting fraud on the government in a wide range of federal False Claims Act and other similar cases. We have the resources, experience, and skill to appropriately investigate even the largest and most complex matters and take them all the way through trial. Learn more about our work in helping individuals expose and stop fraud and obtain recoveries.

Contact us

Please use the form below to contact a False Claims Act lawyer at Lieff Cabraser regarding fraud you have discovered being committed against the government. Our False Claims lawyers will review your claim without fee or obligation, and Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.


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Whistleblower Law Resources

Fraud Against the Government

The United States government provides information and resources relating to the protection of individuals exposing fraud committed against the government. These resources include:

Department of Justice

US Internal Revenue Service Fraud Reporter Resources

US Securities & Exchange Commission

US Commodity Futures Trading Commission

Federal Bureau of Investigation

Contact us

Please use the form below to contact a False Claims lawyer at Lieff Cabraser regarding your fraud-on-the-government lawsuit, or call us toll-free at 1 800 541-7358. Our False Claims attorneys will promptly and confidentially review your inquiry without charge or obligation, and Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.


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Protecting Employees Who Expose Fraud Committed Against the Government

Fraud Against the Government

Lieff Cabraser’s nationally-recognized employment lawyers have secured justice for employees, and helped our clients change the workplace, in a wide variety of employment cases against some of the nation’s largest employers, including Walmart, Home Depot, IBM, Federal Express, Smith Barney, and Best Buy. We have recovered hundreds of millions of dollars in damages, back pay, and/or retirement benefits for workers.

Our employment lawyers are currently litigating precedent-setting class action lawsuits of national importance, including large gender discrimination cases against top Wall Street firms, claims that many of the nation’s largest technology companies have fixed and suppressed high-tech workers’ wages, and claims involving improper wage deductions, as well as ERISA claims on behalf of employees and retirees for pension plan abuses.

Our goal is not only to recover compensation for employees and job applicants who have suffered legal violations but also to require employers to comply with the law. We safeguard employees against retaliation, and understand the risks, and benefits, of exposing fraud or misconduct in the workplace.

Fraud Against the Government Case Lawyers

We represent individuals in a wide range of federal False Claims Act cases. We have the resources, experience, and skill to appropriately investigate even the largest and most complex matters and take them all the way through trial. Learn more about our work in helping individuals expose fraud committed against the government and obtain meaningful recoveries.

Contact us

Please use the form below to contact a False Claims Act lawyer at Lieff Cabraser regarding your fraud-on-the-government lawsuit, or call us toll-free at 1 800 541-7358. Our False Claims attorneys will promptly and confidentially review your inquiry without charge or obligation, and Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.


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Securities Fraud and Financial Fraud Committed Against the Government

Fraud Against the Government

Lieff Cabraser has a long and successful track record of winning tough, complex cases on behalf of investors against powerful corporations and corporate executives who have committed securities and financial fraud. We have tried two federal securities class actions to jury verdicts, prevailing in both, including a $170 million verdict. Working with co-counsel, we have achieved verdicts, judgments, and settlements in excess of $2.5 billion for our clients in securities and investor fraud cases.

Certain kinds of financial fraud cases where the victim is the government can also be brought by individuals under the False Claims Act and other statutes. In particular, the Dodd-Frank Wall Street Reform and Consumer Protection Act provides significant incentives and protections for individuals who provide information on violations of federal securities and commodities exchange laws that result in fraud on the government. These violations can include insider trading, accounting fraud, money laundering, bribing a foreign official, manipulating commodities prices, or manipulating currency exchange rates. Reporting individuals (relators) are also entitled to recover a share of monies owing to the government by virtue of tax fraud.

Today, we serve as co-counsel for the relators in an action against State Street Corporation which serves as the contractual custodian for over 40% of public pension funds in the United States. As the contractual custodian, State Street is responsible for undertaking the foreign currency exchange (FX) transactions necessary to facilitate a customer’s purchases or sales of foreign securities.

The complaint charges that State Street violated the California False Claims Act by systematically manipulating the timing of its execution and reporting of FX trades in order to enrich itself, at the expense of California custodial public pension fund clients, including the California Public Employees’ Retirement System and the California State Teachers’ Retirement System. The case is in the discovery stage after the trial court denied State Street’s demurrer.

We are investigating multiple financial fraud cases where the government was defrauded and several cases have been filed that remain under seal.

Fraud-on-the-Government Lawyers

We represent individuals exposing fraud committed against the government (relators) in a wide range of federal False Claims Act and other similar cases. We have the resources, experience, and skill to appropriately investigate even the largest and most complex matters and take them all the way through trial. Learn more about our work in helping individuals expose and stop fraud and obtain meaningful recoveries.

Contact us

Please use the form below to contact a false claims lawyer at Lieff Cabraser regarding your fraud-on-the-government lawsuit, or call us toll-free at 1 800 541-7358. Our False Claims Act lawyers will promptly and confidentially review your inquiry without charge or obligation, and Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.


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Nursing Home Fraud

Fraud Against the Government

In 2013, U.S. government investigators found numerous examples of poor quality of care, including services related to wound and medication management. The analysis built on a separate report from 2013 that showed Medicare paid $1.5 billion more to nursing homes than they were owed in 2009 because the facilities erroneously billed a quarter of their claims.

Daniel Levinson, the inspector general, said in his report, “These findings raise concerns about what Medicare is paying for.”

Reviewers stated that Medicare paid over $5 billion to nursing homes in 2009 that failed to meet quality-of-care requirements, U.S. government investigators said. In 2012, Medicare paid $32.2 billion to nursing home.

The inspector general today recommended that the Centers for Medicare and Medicaid Services strengthen regulations on care planning, increase surveillance of underperforming nursing facilities and more directly link pay to performance.

Fraud-Against-the-Government Lawyers

We represent individuals in a wide range of federal and state False Claims Act cases. Lieff Cabraser successfully settled a case against a chain of nursing homes for violating importation state laws designed to protect nursing home residents. We have the resources, experience, and skill to appropriately investigate even the largest and most complex matters and take them all the way through trial. Learn more about our work in helping individuals expose and stop fraud against the government and obtain meaningful recoveries.

Contact us

If you have information you believe relates to a False Claims Act case for nursing home or medicare fraud, please use the form below to contact a False Claims Act attorney at Lieff Cabraser, or call us toll-free at 1 800 541-7358. There is no cost or obligation for our review of your fraud on the government case, and Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.


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Military and Defense Fraud

Fraud Against the Government

Military Contractor Fraud and Defense Department Fraud

Ensuring that the United States gets fair value for its military spending is a vital goal with life and death implications. Individuals with knowledge of fraud by defense contractors can help advance safety by, and receive compensation for, reporting fraud.

The False Claims Act offers rewards, as well as protections, for employees of military contractors who report fraud on the Defense Department. Service men and/or women, military workers, accountants, auditors and other persons aware of fraud, false contract claims and/or false certifications with respect to military sales and/or purchases may also be eligible to serve as a whistle blower. The “qui tam” provision of the False Claims Act allows individuals to sue a wrongdoer on behalf of the U.S. government.

Significant Fraud in Defense Contracts

In 2011, the Department of Defense (DOD) released a report on the dollar value of DOD contracts entered into with contractors that were indicted for, settled charges of, fined, or convicted of fraud in connection with any government contracts.

The DOD report found $682 million in such contracts during 2007-2009. In the same period, 43 DOD contractors were suspended from contracting with DOD because of fraud related activities. In the same three-year period, 91 DOD contractors incurred fraud judgments of over $1 million and 120 DOD contractors settled fraud charges for over $1 million; these same contractors were awarded $280 billion in contracts during the same period.

U.S. Senator Bernie Sanders called the DOD’s report “shocking.” Senator Sanders stated, “The ugly truth is that virtually all of the major defense contractors in this country for years have been engaged in systemic fraudulent behavior, while receiving hundreds of billions of dollars of taxpayer money.”

It isn’t just money at stake in defense fraud: Lives hang in the balance. Thousands of brave young soldiers have lost their lives in Iraq and Afghanistan defending United States interests. To the extent that any death or injury was caused by defects in weapons, weapons systems, ammunition, logistics, housing, electrical wiring, planes, helicopters, transport vehicles and the like, contractors should be held to account for their mistakes.

Success in Representing Defense/Military Contractor Employees in False Claims Cases

Lieff Cabraser has significant experience serving individuals who have advanced life and safety interests in connection with contractor weapons failings. We served as co-counsel for a relator (an individual who stepped forward and exposed fraud against the government) who alleged that ATK Launch Systems knowingly sold defective and potentially dangerous illumination flares to the United States military in violation of the federal False Claims Act.

The complaint alleged that ATK knew its flares would ignite when dropped from short distances, in violation of the contract. Lieff Cabraser worked side-by-side with the Department of Justice in litigating the case, including reviewing documents, taking key depositions, preparing experts to support the case, preparing for critical court hearings, and participating in the mediation. In April 2012, the parties reached a settlement valued at $37 million, from which the individual who originally exposed the fraud was also compensated.

Lieff Cabraser also has military contractor fraud cases currently under seal and under investigation. We have developed expertise in evaluating these claims in light of the complex contracts and military regulations that apply.

False Claims Act Attorneys

We represent individuals in a wide range of federal False Claims Act and similar state law cases. We have the resources, experience, and skill to appropriately investigate even the largest and most complex matters and take them all the way through trial. Learn more about our work in helping individuals stop fraud committed against the government and obtain recoveries.

Contact us

Please use the form below to contact a false claims lawyer at Lieff Cabraser regarding your fraud-on-the-government lawsuit or for answers to your questions on False Claims law, or call us toll-free at 1 800 541-7358. Our fraud-against-the-government attorneys will promptly and confidentially review your inquiry without charge or obligation, and Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.


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Medicare Fraud

Fraud Against the Government

What is the False Claims Act for Healthcare?

Many fraud-on-the-government lawsuits have brought to light and ended schemes designed to defraud the Medicare and Medicaid programs. Health care fraud comes in countless varieties, and the government has shown a strong interest in combating it. Some of the most common examples include:

  • Hospitals and doctors billing for services they did not provide, double billing, or purposely using codes that grant them higher reimbursement than they are owed (“upcoding”);
  • Encouraging the use of unnecessary tests as an excuse to bill the government;
  • Pharmaceutical companies promoting prescription drugs for “off-label” uses;
  • Kickbacks among health care providers in order to secure referrals or other business, which is often at issue when there are suspicious and excessive payments from pharmaceutical companies and medical suppliers to doctors; and
  • Providing false pricing data to the government in order to increase Medicare or Medicaid reimbursement amounts.

Assisting Individuals Expose Healthcare Fraud

Lieff Cabraser has extensive experience in prosecuting all types of health care fraud.

We helped obtain a $142 million jury verdict for the Kaiser Foundation Health Plan against Pfizer for fraudulent promotion of the prescription drug Neurontin. We also spearheaded groundbreaking and successful litigation against the largest hospital chain in California for fraudulent billing of anesthesia services, resulting in a record $46 million settlement under a unique California false claims (fraud on the government) statute.

We currently have many cases involving Medicare and Medicaid fraud under seal.

Fraud on the Government Attorneys

We have the resources, experience, and skill to appropriately investigate even the largest and most complex matters and take them all the way through trial. Learn more about our work in helping individuals expose fraud committed against the government and obtain significant recoveries.

Contact us

Please use the form below to contact a False Claims lawyer at Lieff Cabraser regarding your discovery of fraud committed against the government or for answers to your questions about False Claims Act law, or call us toll-free at 1 800 541-7358. Our False Claims lawyers will promptly and confidentially review your inquiry without charge or obligation, and Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.


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Health Care Exchange Fraud

Fraud Against the Government

Exposing Fraud in the Health Insurance Marketplace

The Affordable Care Act represents the most comprehensive reform of our health care system in over a generation. Millions of Americans are eligible to receive federal tax credits that can be used to purchase health insurance from an online marketplace.

Insurance companies that participate in these marketplaces receive billions in federal funding, and that brings with it the potential for fraud. To combat this problem, federal law now provides enhanced financial rewards to whistleblowers who come forward with evidence of fraud involving the market for health insurance.

What Types of Fraud Might Be Perpetrated In Connection with a Health Care Exchange?

Any person who has evidence of fraud against the government involving a health care exchange may take advantage of the Affordable Care Act’s new fraud provisions, which could entitle them to a significant share of the government’s financial recovery. Examples may include:

  • Individuals who purchased health care using federal tax credits, but whose claims were unfairly denied. The Affordable Care Act ensures that all Americans with health insurance will be guaranteed certain benefits, rights, and protections relating to their insurance coverage. For example, the law prohibits insurance companies from imposing unreasonable annual limits on benefits, denying coverage due to a pre-existing condition, or denying coverage for basic health services. If a claim is denied because the insurance company ignores these guarantees, the claimant may recover for exposing the fraud by filing a lawsuit.
  • Employees who learn that their company violated federal regulations. The Affordable Care Act comprehensively regulates insurance coverage. In addition, insurance companies must provide extensive disclosures that employees may participate in a health care exchange. If an employee learns that his or her company violated any of these provisions, or denied its policyholders the new guarantees described above, that employee may file a lawsuit to expose the fraud and share in any recovery.
  • Insiders who learn that an insurance company manipulated the Affordable Care Act’s Premium Stabilization Programs. The Affordable Care Act establishes three programs, often referred to as “the three Rs,” to ensure that insurance premiums remain affordable: Reinsurance, Risk Corridors, and Risk Adjustment. Although each program operates differently, all three involve the transfer of money from the federal government to insurance providers that operate in health care exchanges. If an insider learns that an insurance company has submitted false information to gain access to these funds, or to get more of the funds than it is entitled, that individual may act to expose the fraud.

The False Claims Act Encourages Individuals to Uncover Fraud Against the Government

If you have any evidence of these types of misconduct, or of other misconduct involving violations of the ACA or false statements to the government, you may have a claim under the federal False Claims Act.

The False Claims Act is the government’s primary tool in the fight against fraud. The law encourages individuals who discover fraud against the government to bring suit on behalf of the government and to receive a portion of the government’s damages.

If a person who files such a “false claims” suit receives a favorable judgment or settlement in their case — thus allowing the government to recover money lost in the fraud — the person could receive 15 to 30 percent of that money that is recovered in the case. Ordinarily, the government’s recovery could include up to three times the amount of money it paid out under the false claim, plus an automatic penalty of $5,500 to $11,000 per false claim.

Recently, the Affordable Care Act expanded this provision to deter any potential for fraud involving health care exchange. Now, if any fraud occurs in connection with a health care exchange, the government may recover up to six times its damages.

Taking Action Against Fraud

Before you take any legal action, we recommend you consult with an attorney who has experience handling False Claims Act cases, and who can offer useful advice on how best to proceed and investigate your claims. If you decide to proceed with a qui tam case, your attorney can help you prepare as strong a case as possible.

The more prepared you are before filing suit, the higher your chance of success. It is also important not to discuss the fraud with anyone but your attorneys prior to filing your suit. If others hear of the fraud and file a qui tam suit before you, your suit is at risk of being dismissed. Also, if the government discovers the fraud on its own and starts its own lawsuit or investigation before you file your false claims suit, your suit will be at risk for dismissal.

Fraud Against the Government Lawyers Attorneys

We represent individuals who have discovered fraud committed against the government in a wide range of federal False Claims Act cases. We have the resources, experience, and skill to investigate even the largest and most complex matters and take them all the way through trial. Learn more about our work in helping expose fraud against the government and obtain recoveries for individuals who bring such fraud to light.

Contact us

Please use the form below to contact a False Claims Act lawyer at Lieff Cabraser regarding your fraud-on-the-government lawsuit or for answers to your questions on False Claims Act law, or call us toll-free at 1 800 541-7358. Our False Claims Act lawyers will promptly and confidentially review your inquiry without charge or obligation, and Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.


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Fraud on the Government Law FAQ

Fraud Against the Government

Please use the form at the bottom of this page to contact a False Claims Act attorney at Lieff Cabraser, or call us toll-free in San Francisco at 1 800 541-7358 (ask to speak to attorney Nimish Desai); in New York at 1 888 321-1510 (ask to speak to attorney Rachel Geman); or in Nashville at 1 866 313-1973 (ask to speak to attorney Mark Chalos). There is no charge or obligation for our review of your case.

Attorney Robert Nelson Describes the Top 3 Factors for Government Fraud Relators in Selecting a Lawyer


What is a Government Fraud Relator?

A relator is someone who exposes misconduct, alleged dishonest or illegal activity perpetrated against the government. The alleged dishonest or illegal activity may be classified in many ways: a violation of a law, rule, or regulation, or a direct threat to public interest, such as fraud, health and safety violations, or corruption. False claims relators may make their allegations internally (to other people within the accused organization) or externally (to regulators, law enforcement agencies, to the media or to groups concerned with the issues).

The first False Government Claims protections were enacted in the United States in 1778. The Continental Congress declared it the duty of “all persons in the service of the United States, as well as all other the inhabitants thereof” to inform the Congress or proper authorities of “misconduct, frauds or misdemeanors committed by any officers in the service of these states, which may come to their knowledge.”

Later, as the Civil War devastated the United States, Congress enacted one of the first laws that protected individuals exposing fraud against the government, the 1863 United States False Claims Act (revised in 1986), which was enacted to combat fraud by military suppliers. The act encourages individuals reporting such fraud by promising them a percentage of the money recovered or damages won by the government and protects them from wrongful dismissal.

In 1986, Congress recognized that the government, with its limited resources, could not on its own combat all of the fraud that was being perpetrated by contractors and those who receive payments from the government for services. Congress reinvigorated the False Claims Act by strengthening its qui tam section to create incentives for private citizens to help the government fight fraud and recover monies owed to the government.

Relators frequently face reprisal, sometimes at the hands of the organization or group which they have accused, sometimes from related organizations, and sometimes under law.



What is the False Claims Act?

The False Claims Act (FCA) is a federal law (31 U.S.C. Sections 3729 through 3733) that prohibits people from defrauding the federal government by knowingly presenting (or causing to be presented) a false or fraudulent claim to the government for payment. The FCA was designed to help U.S. taxpayers recover money stolen from the federal government.

False Claims Act cases involve a variety of government programs and/or contracts. Virtually any type of fraud in which the government has paid money, or has been billed for money, based on false claims will likely fall under the False Claims Act. Many successful False Claims Act cases have involved Medicare and military contracting fraud. Other successful cases have dealt with federal funding for environmental, anti-terrorism, energy, farm, and education programs.

Here are some examples of frauds that have been prosecuted under the False Claims Act:

  • Billing the government for services and goods that were never rendered or delivered.
  • Selling the government broken or untested equipment that fails to comply with contract specifications.
  • Being overpaid by the government for a good or service and not reporting it.
  • Skimming profits off the sale of municipal bonds.
  • Mining or harvesting more natural resources from public lands than reported to the government.
  • Lying to the government about the value of imported goods, or about where the goods came from.
  • Lying to the government about whether a contractor is a member of a minority group or a veteran.
  • Billing the government for research that never occurred or was falsified.



Who can be a relator?

Any person or entity that has evidence of a fraud occurring against federal contracts or programs can act as a relator (report the fraud) under the False Claims Act. Typically, the relator is or was employed by the company engaged in the wrongdoing. The False Claims Act has express language forbidding retaliation by employers against relators.


What is Qui Tam and how does it relate to claims of fraud against the government?

The “qui tam” provision of the False Claims Act (fraud-on-the-government law) allows a person or persons to report the fraud and sue the wrongdoer on behalf of the U.S. government. In such cases, those exposing the fraud are referred to as “relators.” “Qui tam” comes from a Latin phrase meaning “he who sues for the king as well as for himself.” Typically, the relator is or was employed by the company engaged in the wrongdoing. The FCA has express language forbidding retaliation by employers against relators.


Why was the False Claims Act created?

In 1986, Congress recognized that the government, with its limited resources, could not on its own combat all of the fraud that was being perpetrated by contractors and those who receive payments from the government for services. Congress reinvigorated the False Claims Act, a Civil War-era law, by strengthening its qui tam section to create incentives for private citizens to help the government fight fraud and recover monies owed to the government.


What are typical health care fraud cases under the False Claims Act?

Here are some examples that apply specifically to the field of health care:

  • Performing and billing the government for unnecessary medical procedures in order to increase the amount of Medicare reimbursement.
  • Charging the government twice for a service or good that only should have been billed once (double billing).
  • Billing the government for brand name drugs where generic drugs were actually used.
  • Using multiple billing codes on medical tests in order to increase government reimbursement for the test (unbundling).
  • Lying to the government about the true wholesale price of prescription drugs in order to receive a greater reimbursement.
  • Lying to the government by reporting – via billing codes – that a patient’s illness and costs were greater than they actually were (“upcoding”).
  • Charging the government for work performed by a doctor that was actually performed by a nurse or resident intern.
  • Unfairly billing by nursing homes to Medicare for certain services.
  • Accepting unqualified patients or improperly revoking a patient’s hospice admission by hospice providers to take advantage of Medicare.



What if someone has already filed a False Claims Act suit against the company I'm thinking of suing under the False Claims Act?

If another person or the government has already filed a False Claims Act suit based on the same fraud you’re aware of, it is possible your suit could be dismissed. This aspect of the False Claims Act is sometimes called the “first to file” rule. That is why it is important to file your False Claims Act suit as soon as possible.


What are the benefits of reporting fraud against the government?

In addition to the benefit of helping to eliminate fraud against the government, there are important financial rewards. If a person who files a qui tam suit receives a favorable judgment or settlement in their case – thus allowing the government to recover money lost in the fraud – the person could receive 15 to 30 percent of the money that is recovered in the case. The government’s recovery could include up to three times the amount of money it paid out under the false claim, plus a penalty of $5,500 to $11,000 per false claim.

In order to be eligible to receive a portion of this payout, a person must have formally filed a qui tam suit.

Merely informing the government of the fraud is not enough under the False Claims Act.



What should I do if I know about fraud against the government?

Before you take any action, it is a good idea to consult an attorney who has experience handling False Claims Act cases and who can offer useful advice on how best to proceed and investigate your claims. If you decide to proceed with a qui tam case, your attorney can help you assemble as strong a case as possible. The more prepared you are before filing a suit, the higher your chance of success. It is also important not to discuss the fraud with anyone except your attorneys prior to filing your suit. If others hear of the fraud and file a qui tam suit before you, your suit is at risk of being dismissed. If the government discovers the fraud on its own and starts its own lawsuit or investigation before you file your qui tam suit, your suit will also be at risk for dismissal.


If I know about fraud, how quickly must I act? Is there a statute of limitations?

Under the False Claims Act, a qui tam suit must be filed: (1) within six years from the date of the fraud; or (2) three years after the government knew or should have known about the fraud, and no later than 10 years after the fraud. Despite this lengthy period, the general rule is that the sooner you file your case, the better.


Would my employer know right away if I decided to file a qui tam suit or report their fraud to the government?

Your employer should not know about the lawsuit and subsequent government investigation for at least several months or possibly even years. Qui tam suits are filed under seal and kept secret under the False Claims Act. Attorneys and government agents involved in investigating the allegations in a qui tam suit are not permitted to reveal any information about the suit while it’s being investigated. However, once the investigation is completed, the suit is made public and the employer/defendant is notified.


What role does the government play in a False Claims Act lawsuit?

Once you have filed your qui tam suit under the False Claims Act, the government may decide to join your side in the suit. It is usually advantageous if the government decides to join your suit because your case will have the resources of the U.S. Department of Justice at its disposal. If the government declines to join you in your case, you can still proceed with it alone.

Working with experienced attorneys who have the capacity and experience to investigate and litigate complex cases from start to finish can increase the likelihood of the government joining your case, and having a knowledgeable and experienced False Claims lawyer is absolutely critical to the success of your case if the government declines intervention.



What are the remedies for False Claims Act violations?

Those who violate the False Claims Act can be liable for three times the amount that the government was defrauded, plus penalties of $5,500 to $11,000 for each false claim.

Each time the violator fraudulently billed the government counts as a separate claim. As a result, penalties can be an important component of an False Claims Act claim.



What if I have information on a state being defrauded, as opposed to the federal government?

Many states have their own version of the False Claims Act to discourage frauds against state and local governments. Among those states are: California, Delaware, Washington D.C., Florida, Georgia, Hawaii, Illinois, Indiana, Louisiana, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oklahoma, Rhode Island, Tennessee, Texas, Virginia, and Wisconsin.

Some states have laws that mirror the federal False Claims Act; others have laws limited to health care fraud; still others have unique provisions. It is important for your attorneys to be aware of these state-specific provisions.



What about tax fraud?

The U.S. tax code has its own provisions that allow relators to obtain a reward for reporting tax fraud. As with the False Claims Act, the IRS False Claims provisions provide for relators to be awarded 15 to 30 percent of the amount recovered, plus triple damages.


What about securities fraud and other types of financial fraud?

The Dodd-Frank Wall Street Reform and Consumer Protection Act allows for any individual, or for two or more individuals acting jointly, to receive a reward if they provide the Securities and Exchange Commission (SEC), Commodity Futures Trading Commission (CFTC), or other agencies with information about violations of federal securities laws. Examples of securities laws violations that would fall into this category are insider trading, accounting fraud, bribing a foreign official (Foreign Corrupt Practices Act violations), and money laundering.

In order to receive a reward, the information turned over by the relator must lead to the government recovering $1 million or more.

If that requirement is met, the relator — the individual reporting the fraud — can receive from 10 to 30 percent of the amount the government recovers.

The Dodd-Frank provisions also offer False Claims Act-like protections against retaliation by employers.

Lieff Cabraser can provide valuable assistance for individuals considering reporting securities or tax fraud they know to be occurring against the government. As with False Claims Act suits, seeking an attorney’s advice prior to filing such a suit is highly recommended and can maximize your likelihood of success.



What are the risks associated with exposing fraud being perpetrated against the government? How would the False Claims Act protect me?

Unfortunately, relators are commonly subject to retaliation. However, the protections have dramatically expanded in recent years as a result of the passage of new laws and pro-employee interpretations of existing law. One example is the explicit anti-retaliation provision under the False Claims Act. The degree of legal protection a relator receives depends on the type of fraud, the role of the relator, and the type of company, among other issues.


How do I protect myself from retaliation for exposing fraud against the government?

It is important that you seek legal advice early and meet with counsel. Lieff Cabraser has a nationwide, top-rated employment practice dedicated to protecting employees who have been treated unfairly, including being retaliated against by their employers for challenging illegal practices. Our False Claims Act and employment attorneys can advise you on whether and how to serve as a relator and can protect you against retaliation.


Who can I contact for help in evaluating my case?

Lieff Cabraser has an active practice representing those exposing fraud against the government in both federal and state False Claims Act cases. Our attorneys are highly experienced and have a track record of success with such suits. We will review your claim for free and with no obligation. Please call us toll-free at 1-800-541-7358 (San Francisco office, ask for attorney Nimish R. Desai), 1-888-321-1510 (New York office, ask for attorney Rachel Geman), or 1-866-313-1973 (Nashville office, ask for attorney Mark P. Chalos).


Contact us

We will review your claim without fee or obligation, and Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.


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Avaya Lucent AT&T

Whistleblower

Result: $21.75 million settlement
Year: 2010

Lieff Cabraser represented whistleblowers in litigation alleging that defendants Avaya, Lucent Technologies, and AT&T violated the Federal Civil False Claims Act (31 U.S.C. §§ 3729 et seq., as amended), and the False Claims Acts of California and several other states.

The complaint alleged that defendants charged governmental agencies for the lease, rental, and post-warranty maintenance of telephone communications systems and services that the governmental agencies no longer possessed and/or were no longer maintained by defendants. In November 2010, the parties entered into a $21.75 million settlement of the litigation.

ATK Defective Flares Sold to U.S. Military

Whistleblower

Result: $37 million settlement
Year: 2012

United States ex rel Dye v. ATK Launch Systems, Inc. Whistleblower Case

Lieff Cabraser served as co-counsel for a whistleblower who alleged that ATK Launch Systems knowingly sold defective and potentially dangerous illumination flares to the United States military in violation of the federal False Claims Act. The specialized flares were used in nighttime combat, covert missions, and search and rescue operations. A key design specification set by the Defense Department was that these highly flammable and dangerous items ignite only under certain conditions.

The complaint alleged that the ATK flares at issue could ignite when dropped from a height of less than 10 feet – and, according to ATK’s own analysis, from as little as 11.6 inches – notwithstanding contractual specifications that they be capable of withstanding such a drop. In April 2012, the parties reached a settlement valued at $37 million.

Sutter Health Fraudulent Anasthesia Billing

Whistleblower

Result: $46 million settlement
Year: 2013

In a case that received widespread media coverage, Lieff Cabraser represented whistleblower Rockville Recovery Associates in a qui tam suit for civil penalties under the California Insurance Frauds Prevention Act (“IFPA”), Cal. Insurance Code § 1871.7, against Sutter Health, one of California’s largest healthcare providers, and obtained the largest penalty ever imposed under the statute. The IFPA is designed to prevent fraud against insurers and, by extension, their policyholders by imposing civil penalties payable to the State for false claims submitted to private insurers.

The complaint alleged that the 26 Sutter hospitals throughout California submitted false, fraudulent, or misleading charges for anesthesia services (separate from the anesthesiologist’s fees) during operating room procedures that were already covered in the operating room bill.

After Lieff Cabraser defeated Sutter Health’s demurrer and motion to compel arbitration, California Insurance Commissioner Dave Jones intervened in the litigation in May 2011. Lieff Cabraser attorneys continued to serve as lead counsel and litigated the case for over two more years. In all, plaintiffs defeated no less than 10 dispositive motions, as well as three writ petitions to the Court of Appeals. Because the IFPA was a largely untested statute, just about every aspect of the statute had to be litigated. One important ruling, critical to future litigants, was that the IFPA requires a trial by jury.

The parties reached a $46 million settlement that was announced in November 2013, shortly before trial was scheduled to commence. This is the largest award ever under the IFPA, and per the statute, will fund additional anti-fraud efforts by the State.

In addition, Sutter Health agreed to a comprehensive series of billing and transparency reforms, which California Insurance Commissioner Dave Jones called “a groundbreaking step in opening up hospital billing to public scrutiny.” On the date the settlement was announced, the California Hospital Association recognized its significance by issuing a press release stating that the settlement “compels industry-wide review of anesthesia billing.”

Defendant Multiplan, Inc., a large leased network Preferred Provider Organization, separately paid a $925,000 civil penalty for its role in enabling Sutter’s alleged false billing scheme.

Office Depot False Discount Pricing

Whistleblower

Result: $77.5 million settlement
Year: 2015

On February 11, 2015, a California Superior Court approved a $77.5 million settlement with Office Depot to settle a whistleblower lawsuit brought under the California False Claims Act.

The whistleblower was a former Office Depot account manager. The City of Los Angeles, County of Santa Clara, Stockton Unified School District, and 16 additional California cities, counties, and school districts intervened in the action to assert their claims (including common-law fraud and breach of contract) against Office Depot directly.

The governmental entities purchased office supplies from Office Depot under a nationwide supply contract known as the U.S. Communities contract. Office Depot promised in the U.S. Communities contract to sell office supplies at its best governmental pricing nationwide. The complaint alleged that Office Depot repeatedly failed to give most of its California governmental customers the lowest price it was offering other governmental customers. Other pricing misconduct was also alleged.

Robert Nelson and Lexi Hazam of Lieff Cabraser represented the whistleblower and the California cities, counties, and school districts that intervened in the suit, together with Eric Havian, Stephen Hasegawa and Edward Arens of Phillips & Cohen LLP; Altomease Kennedy of Sanford Heisler; and Mark Kleiman of the Law Office of Mark Kleiman.

Contact Lieff Cabraser

If you are a whistleblower and wish to report a fraud against the government or by your company, please contact us using the form below. Please describe the fraud and identify the company involved.

We will review your claim without fee or obligation, and Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.

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University of Phoenix

Whistleblower

Result: $78.5 million settlement
Year: 2009

Lieff Cabraser obtained a record whistleblower settlement against the University of Phoenix (“Phoenix”) in a case that charged that Phoenix had violated the Higher Education Act (“HEA”) by providing improper incentive pay to its recruiters. The HEA prohibits colleges and universities whose students receive federal financial aid from paying their recruiters based on the number of students they enroll, which creates a risk of encouraging recruitment of unqualified students who Congress has determined are more likely to default on their loans. High student loan default rates not only result in wasted federal funds, but the students who receive these loans and then default are burdened for years with tremendous debt without the benefit of a college degree.

Video – Whistleblower False Claims Act Lawyer: Record Settlement in Lawsuit

The complaint alleged that Phoenix defrauded the U.S. Department of Education by obtaining federal student loan and Pell Grant monies from the federal government based on false statements of compliance with HEA. In December 2009, the parties announced a $78.5 million settlement. The settlement constitutes the second-largest settlement ever in a False Claims Act case in which the federal government declined to intervene in the action and largest settlement ever involving the Department of Education.

The University of Phoenix case led to the Obama Administration passing new regulations that took away the so-called “safe harbor” provisions that for-profit universities relied on to justify their alleged recruitment misconduct. For his outstanding work as Lead Counsel and the significance of the case, California Lawyer magazine recognized Lieff Cabraser attorney Robert J. Nelson with a California Lawyer of the Year (CLAY) award.

Unnecessary Surgery (Heart Stent Implants)

Whistleblower

Issue: Fraud in Medicare and Medicaid

Lieff Cabraser is investigating cases of alleged waste, fraud and abuse of the federal Medicare and Medicaid programs, as well state-funded health care programs, due to unnecessary cardiac stent implantations.

Unnecessary Heart Stent Surgery False Claims Cases

In December 2010, the U.S. Senate Finance Committee detailed the case of a physician who reportedly implanted nearly 600 potentially medically unnecessary stents from 2007 through mid-2009 at St. Joseph Medical Center in Towson, Maryland, and his relationship with the manufacturer of the stents, Abbott Labs. The report found that the questionable stent implantations cost the Medicare program $3.8 million during that period. Other similar cases of apparently improper cardiac procedures have been uncovered at medical facilities across the country.

Commenting on the report, U.S. Senator Max Baucus stated, “Hospital patients expect their care to be based on medical need, not profits. Doctors should not be performing invasive medical procedures patients don’t need, and taxpayers certainly shouldn’t be paying for these wasteful and improper implantations.”

From fiscal year 2004 to fiscal year 2009, the Medicare program paid over $25 billion for cardiac stent procedures. Fraud, waste and abuse in the health care system is estimated to cost Americans at least $60 billion a year – three percent of total health care spending.

Unnecessary Defibrillator Implantation

In a December 2010 study published in the Journal of the American Medical Association, the authors examined more than 100,000 cases of implantable cardioverter-defibrillator (or ICDs), and found that in 22.5% of cases patients did not meet expert guidelines that determine when an ICD implant surgery should be performed.

As reported in The New York Times, lead author of the report Dr. Sana Al-Khatib stated, “I’m sure some of these cases were reasonable. The physicians did what they thought was best. But even taking that into account, 22.5 percent is way too high.”

About the False Claims Act and Actions Brought By Whistleblowers

The False Claims Act prohibits persons from defrauding the federal government by knowingly presenting a fraudulent claim for payment. The Act is designed to prevent damages to the U.S. Treasury by causing the U.S. to pay out money it was not obligated to pay. Violations of the False Claims Act can result in judgment against a defendant in an amount equal to three times the amount of damages the U.S. Treasury sustained, plus civil fines.

Contact Lieff Cabraser

Lieff Cabraser has an active practice representing whistleblowers in False Claims Act cases (also referred to as Qui Tam cases).

If you are aware of hospital, medical facility or doctors group that has performed unnecessary stent or other wasteful medical procedures, please use the form below to contact a Lieff Cabraser attorney. All inquiries will be held confidential and there is no charge or obligation for our review of your case.

We will review your claim without fee or obligation, and Lieff Cabraser agrees to protect your name and all confidential information you submit against disclosure, publication or unauthorized use to the full extent under the law.

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