Defending False Claims Act Allegations

Defending False Claims Act Allegations

The False Claims Act is designed to combat fraud against the government. The statute provides that any person who knowingly presents a fraudulent claim for government payment, conspires to do so, or receives funds in connection with such activity is liable to the United States Government for a civil penalty. 31 U.S.C. §3729.

Doctors and other health care providers who knowingly submit false or fraudulent claims to Medicare, Medicaid, or other public health care benefit programs may be liable under the False Claims Act. Knowledge of the falsity can be proven by actual knowledge, deliberate ignorance of the falsity of the information, or a reckless disregard for the truth or falsity of the information. 31 U.S.C. §3729(b)(1).

Violations of the False Claims Act are pursued as civil actions. Criminal charges for alleged health care fraud can be charged under the federal Health Care Fraud statute and/or the Conspiracy to Commit Health Care Fraud statute, 18 U.S.C. §1347 and 18 U.S.C. § 1349, respectively. It is possible that a parallel civil proceeding to recoup funds under the False Claims Act will be initiated by the Government even after bringing an indictment for criminal charges.

False Claims Act Allegations

Alleged violations of the False Claim Act in the health care field can be for any number of activities. Possible violations of the Act include Medicare Fraud, Medicaid Fraud, billing the government for medical services not performed or not medically necessary, billing for the same procedure multiple times, upcoding by using an improper billing code to get paid for a more expensive procedure than was actually performed, billing the government for patients who do not exists, or billing for medical equipment that was never provided. Any health care fraud scheme that presents fraudulent claims to the government can give rise to civil action under the False Claims Act.

Certainly, False Claims Act cases are prevalent in the health care industry as well as a number of other industries. Employers who allegedly perpetuate fraud can exists in a wide-variety of occupations and professions, including health care, banking, securities, real estate, construction, defense contractors, or education, just to name a few.

Defending False Claims Act Allegations

No matter your industry, we are prepared to help you. If you have been accused of misconduct under the False Claims Act, or served in a Qui Tam case, it is critical that you hire a defense attorney skilled in this complex area of law.

Our firm has successfully represented numerous health care clients, including hospitals, physicals, pharmacies, and other health care providers. Ashley D. Adams, President and CEO of Ashley D. Adams, PLC, specializes in white collar criminal defense cases, representing corporate and individual clients in federal and state criminal trials, investigations, health care fraud cases, and regulatory and administrative matters.

Attorney Adams is a former United States Assistant Attorney. She served as a member of the DOJ’s Health Care Fraud Task Force investigating alleged frauds perpetrated by and against health care providers and hospitals. She was selected by National Trial Lawyers as one of the “Top 100” attorneys in criminal defense, and as one of Arizona’s Best Lawyers and Southwest’s Super Lawyers annually since 2010.

The best defense begins as soon as you are notified of an investigation or charges filed against you. A swift and ongoing defense helps to ensure the best possible outcome in your case.

Contact us here or call now (480) 219-1366 for a case evaluation and consultation to learn about your rights.


The attorneys at Ashley D. Adams, PLC handle state criminal cases throughout Arizona and federal criminal cases throughout the United States, including Arizona, Oklahoma, Utah, and California.