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Tennessee False Claims Act Lawyer Reports Sleep Clinic Medicare Fraud

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FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

The Tennessee False Claims Act provides incentives for Tennessee whistleblowers reporting fraudulent activities impacting the government over a broad area. A qui tam lawsuit can be filed in federal court alleging violation of the False Claims Act. In Jacksonville, Florida, federal prosecutors have settled part of a lawsuit brought by a qui tam relator alleging a sleep clinic intentionally billed the government for millions of dollars of services that were not medically necessary and in some instances were never performed.  The complaint alleges that the defendants, including four physicians and one sleep clinic, knowingly submitted false claims.

A Tennessee sleep clinic cannot fraudulently bill Medicare or TennCare for unnecessary or unperformed work.  Such an action is tantamount to a claim under the Tennessee False Claims Act, which must be filed under seal in federal court.  Our team of lawyers represents relators under the False Claims Act. Visit here for more information.

In the Florida sleep clinic case, the relator (and government) alleged that the Sleep Medicine Clinic and Dr. Hubert Zachary and Dr. George Restea submitted claims for polysomnographic sleep studies that were not medically necessary, not conducted appropriately by licensed individuals or were not actually performed.  Tennessee Medicare Fraud is not allowed and may be challenged by a whistleblower. The Sleep Center has agreed to pay $200,000 to resolve claims and be excluded from participation in federal health care programs for 8 years.  Dr. Restea agreed to pay nearly $100,000 to settle the claims.

The government will move forward against two other doctors: Dr. John DeCerce and Dr. George Young, whom the government contends merely lent their name to the Sleep Clinic in exchange for compensation. For example, the Complaint alleges that Dr. Young signed Durable Medical Equipment orders for patients that he never saw and sleep study interventions even when the machines allegedly performing the approved studies were broken.

The relator, a former employee named Donna Nichols, will receive more than $60,000 as a relator fee.  Such a fee is allowed under the Tennessee False Claims Act.

Contact a Tennessee False Claims Act Attorney

We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

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    Tennessee False Claims Act Lawyer Reports $10 Million Whistleblower Lawsuit

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    FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

    The Tennessee False Claims Act provides incentives for Tennessee whistleblowers reporting fraudulent activities impacting the government over a broad area. A qui tam lawsuit can be filed in federal court alleging violation of the False Claims Act.

    One such case was recently filed against the Chattanooga EPB, which has been hit by a $10 million dollar whistleblower lawsuit. Whle this case was not filed under the Tennessee False Claims Act, it is still possible to bring such a claim under Tennessee’s whistleblower law.  This law allows individuals to bring lawsuits on behalf of cities or the state, with a large portion of the damages being returned to taxpayers.  The city may opt not to take the lead in such a lawsuit, instead allowing co-plaintiffs like Mr. Lepard (who filed the EPB matter) to pursue the case.

    If his suit is successful, Mr. Lepard is allowed to receive between 25 and 50 percent of any damages awarded under the statute governing whistle-blower lawsuits.  Under the Tennessee False Claims Act, the percentage of recovery for a qui tam relator is lower.  In fact, national averages are approximately 16% paid to the relator.

    The False Claims Act has one of the strongest whistleblower protection provisions in the United States. However, it has many complicated components and requirements, which can harm any person that pursues such a claim without counsel. Due to the potential for a significant financial recovery, it is usually possible to retain an attorney for such an action.  Our team of attorneys in Tennessee is ready to help you.

    Contact a Tennessee False Claims Act Attorney

    We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

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      Tennessee False Claims Act case settles for $762,000

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      FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

      The Tennessee False Claims Act provides incentives for Tennessee whistleblowers reporting fraudulent activities impacting the government over a broad area. It allows filing of qui tam lawsuits in Tennessee courts by whistleblowers or relators seeking prosecution of the guilty and recovery of defrauded taxpayers’ money. One area of False Claims Act involves governmental construction fraud.  A recent settlement in Tennessee resulted in $762,000 in payments for fraud.

      Tennessee False Claims Act Government Contractor Fraud

      A federal judge in Nashville, Tennessee has ordered that a defendant, Circle C Construction, LLC, pay $762,894.54 to the United States for Tennessee False Claims Act violations connected with a construction contract at Fort Campbell military base.  Circle C is a construction contractor based in Kentucky.  Our team of lawyers help whistleblowers file claims under both the Tennessee False Claims Act and the Kentucky False Claims Act.

      The United States of America brings a case on behalf of a relator in a false claims act matter.  Here, the United States originally intervened in the lawsuit against Circle C in 2007, after District Judge William J. Haynes entered summary judgment on both liability and damages against Circle C.  Following an appeal, the Sixth Circuit Court of Appeals held that the award of damages was not appropriate and that a new trial should be ordered as to damages only.  Therefore, Judge Kevin H. Sharp presided over a damages trial in March 2014.  On August 22, 2014, Judge Sharp announced his decision awarding $762,894.54 to the Unite States in the case.  Specifically, Judge Sharp awarded $259,298.18 for the electrical portion of the affected buildings constructed by Circle C.

      The allegatiuon was the Circle C submitted false payroll certifications to Fort Campbell.  Circle C represented the electrical contractor wages were the prevailing wages under the Davis-Beacon Act.  The Davis–Bacon Act of 1931 is a United States federal law that establishes the requirement for paying the local prevailing wages on public works projects for laborers and mechanics. It applies to “contractors and subcontractors performing on federally funded or assisted contracts in excess of $2,000 for the construction, alteration, or repair (including painting and decorating) of public buildings or public works.”  The Government alleged that Circle C was not actually paying electrical subcontractor wages.

      Judge Sharp tripled the damages from $259,298.18 to $762,894.54.  Brian Wall is the relator who filed this case under the Tennessee False Claims Act.

      Contact a Tennessee False Claims Act Attorney

      We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

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        Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

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        Kentucky False Claims Act Case Results in $16.5 Million Settlement

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        FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

        The Kentucky False Claims Act provides incentives for Kentucky whistleblowers reporting fraudulent activities impacting the government over a broad area. It allows filing of qui tam lawsuits in Kentucky courts by whistleblowers or relators seeking prosecution of the guilty and recovery of defrauded taxpayers’ money. One area of False Claims Act involves Hospital Fraud.

        Kentucky False Claims Act: Hospital Pays $16.5 Million To Settle Whistleblower Lawsuit

        St. Joseph Hospital of London paid $16.5 million to settle a Kentucky False Claims Act lawsuit that accused the health care center of pervasive false billing for Medicaid and Medicare reimbursements. The hospital allegedly bribed cardiologists who superfluously referred patients for heart procedures and doctors at the hospital also performed needless surgeries to bill more. Kentucky qui tam lawsuits have led to the recovery of more than $50 million health care funds from hospitals in the last six months. Ashland-based King’s Daughters Medical Center also agreed to pay $40.9 million in June 2014 after investigations indicted it for seeking federal reimbursements for unneeded medical procedures carried out on patients.

        The federal false claim act that applies to the state in the absence of any such law of its own mandates a reward amounting to 15 to 30 percent of the total amount settled for whistleblowers and initiators of qui tam lawsuits in Kentucky.

        Qui Tam Lawsuit Against St. Joseph Hospital

        A whistleblower lawsuit was filed in 2011 against the hospital, owned by Denver-based Catholic Health Initiatives and now part of KentuckyOne Health, for paying to cardiologists who unnecessarily referred patients for expensive heart procedures, such as bypass surgery, that were not actually needed. Three doctors from Lexington initiated the qui tam lawsuit in Kentucky according to the federal false claims act after they discovered the wrongdoing by the hospital management. They examined many patients, who were treated at St. Joseph hospital, to realize that their medical history did not require procedures they were recommended to undergo at the health care center between 2008 and 2011.

        The Kentucky qui tam lawsuit led to further investigations by the authorities and one of the doctors who was accused of receiving kickbacks for unnecessarily sending patients to the hospital turned an approver. He admitted to have falsified diagnoses to refer patients to St. Joseph, which, in turn, paid money and allowed him and other doctors to seek facility fee from Medicaid and Medicare funds as a hospital subsidiary. The sham system of false billing also included hundreds of unnecessary stent insertion and other heart procedures performed on these patients.

        St. Joseph hospital got $10,000 to $20,000 in health care reimbursements for each heart procedure billed, the Kentucky false claim lawyer representing the plaintiffs claimed. About $2.5 million is awarded to the three whistleblowers as per legal provisions.

        Kentucky False Claims Act Lawsuit: Things To Know

        • Kentucky has no false claims act of its own. All whistleblower actions in the state are covered under the federal false claims act that encourages citizens to file a claim for themselves and on behalf of the state based on their information on defrauding of public money.
        • A qui tam litigation is a civil action and only punishable with monetary fine. However, it does not forbid any criminal action by affected individuals. St. Joseph faces over 200 medical malpractice lawsuits, claiming unnecessary medical procedures at the health care facility.
        • Filing a false claim lawsuit in Kentucky must be done within six years of the fraud committed or within three years of its discovery subject to a maximum of 10-year limitation.
        • Whistleblowers are set to 15 to 30 percent of the total recovery, including fines, punitive damages, and defrauded money, as incentive. The award is on the higher side when they fight their own Kentucky false claims lawyers without any participation of the state. When public prosecutors take up the case, they are assured of at least 15 percent of the settled amount.
        • A qui tam lawsuit can be brought in Kentucky against any type of fraud, leading to losses to the national exchequer or false submission or misrepresentation.
        • There is a provision for comprehensive protection of a Kentucky whistleblower from any retribution or retaliation.

        Court our team of Kentucky false claims act lawyers to guide you through the complex legal process.

        Contact a Kentucky False Claims Act Attorney

        We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

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          Tennessee False Claims Act Lawyer Discusses Nursing Home Medicaid Fraud

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          FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

          The Tennessee False Claims Act provides incentives for Tennessee whistleblowers reporting fraudulent activities impacting the government over a broad area. It allows filing of qui tam lawsuits in Tennessee courts by whistleblowers or relators seeking prosecution of the guilty and recovery of defrauded taxpayers’ money. One area of False Claims Act involves Nursing Homes committing Medicare and Medicaid Fraud.

          Tennessee False Claims Act Medicare and Medicaid Fraud

          Entities, private individuals, or businesses in the state can be named as defendants in qui tam lawsuits filed according to the protocol laid in the Tennessee False Claims Act, if they are directly responsible or party to any of the following fraud committed. These entities include nursing homes.  In fact, one nursing home company (Rochelle) recently settled a False Claims Act case in New York for $2.2 Million Dollars upon allegations that it submitted 62,000 false claims to the joint state and federal program between 2002 and 2006.  Similar conduct would be improper under Tennessee law and warrant the filing of a Tennessee False Claims Act lawsuit.

          The Rochelle company allegedly used Medicaid reimbursement rates based, in part, on up-coded Patient Review Instruments, which false represented the degree of care required by many Glen Island residents during the mandatory quarterly assessment periods covered by these submissions.  The Rochelle nursing home also allegedly exaggerated residents’ diagnoses, conditions and required treatments in reports and routinely stated that residents were receiving treatments, including for oxygen and suctioning, when such treatments were neither required nor given.  Our False Claims Act attorneys have successfully handled a Tennessee False Claims Act case involving upc0ding allowing the return of hundreds of thousands of dollars to the Government.

          The False Claims Act claim involved a nursing home allegedly attempting to cover up their fraudulent submissions and false claims by making false entries and forgeries into Glen Island residents’ medical records.  These falsified medical records were turned over in an investigation, and I believe led to the $2.2 Million Dollar False Claims Act settlement.

          Contact a Tennessee False Claims Act Attorney

          We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

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            Tennessee False Claims Act: Types of Frauds Covered

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            FALSE CLAIMS FREE CASE EVALUATION: 1-800-632-1404

            Tennessee False Claims Act Lawsuits Are Being Filed

            The Tennessee False Claims Act provides incentives for citizens reporting fraudulent activities impacting the government over a broad area. It allows filing of qui tam lawsuits in Tennessee courts by whistleblowers or relators seeking prosecution of the guilty and recovery of defrauded taxpayers’ money. Apart from a slew of measures ensuring safety and security of whistleblowers, the False Claims Act in Tennessee also provides for reward to relators for their assistance in retrieval of embezzled state funds. In 2013, funds exceeding $3 billion were successfully recovered following more than 850 active interventions of whistleblowers and their false claim lawyers nationwide and at least $387 million in awarded to them for their acts of patriotism.  In other words, Tennessee False Claims Act relators have been awarded over $387 Million Dollars.

            Types of Cases Under the Tennessee False Claims Act

            Entities, private individuals, or businesses in the state can be named as defendants in qui tam lawsuits filed according to the protocol laid in the Tennessee False Claims Act, if they are directly responsible or party to any of the following fraud committed.

            • Pharmaceutical Frauds, such as off-label marketing, offering kickbacks to promote products, violation of good manufacturing practice, fraudulent price hike, selling of drugs without adhering to Drug Effectiveness Study Implementation protocols, medical device fraud, reporting false price to defraud Medicaid, and compound drug making without FDA approval.
            • Healthcare Frauds, includingmaking fraudulent claims for reimbursement, upcoding, overbilling, non-compliance to relevant equipment procurement laws, intentional inaccurate billing, unnecessary medical services, violation of anti-Kickback Statute, infringement of the Stark Statute of 1989 on overutilization of medical procedures, ambulance fraud, etc. It is one of the most reported frauds in Tennessee and the state has a separate Medicaid False Claims Act to deal with all these frauds.
            • Financial Transaction Frauds, such as deceitful financial transactions, supplying goods and services to the state at a rate higher than the market prices, conning the government in financial dealings, improper request for support under the Troubled Asset Relief Program, and submitting falsified information to seek government financial assistance in the form of loan guarantees or HUD funds. Though there are a few instances of financial transaction frauds, qui tam lawsuits filed on such false claims are highly lucrative due to a large amount of rewards for whistleblowers.
            • Procurement Frauds, including false payment claims, providing sub-standard goods and services, overcharging for services or goods supplied, offering kickbacks, rigging bids to get procurement contracts, material violation of contracts, mid-way price hike, overpayment, and failure to deliver according to contract conditions.
            • Defense Contractor Fraud, such as cross-charging, overcharging, change of fixed price to cost-plus system, providing substandard products, inflation of costs, contract term violation, wrong product substitution, etc.

            The broad-worded statute of the Tennessee False Claims Act encourages citizens to help the government track down fraudulent activity and ensure the most effective use of the public money. Though the Act enunciated tough provisions to deter anyone from perpetrating fraud against the state, there has been a surge of discovery of such incidents in the last few years, with 2013 witnessing about 89 percent increase in qui tam lawsuits. However, an effective litigation leading to successful recovery award requires support and guidance of a skilled, qualified, expert, and professional False Claims Act attorney.

            FOR FALSE CLAIMS ACT HELP, PLEASE CONTACT US.

            We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

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              Tennessee False Claim Act Case Yields Ambulance Service Pays $500,000

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              Tennessee False Claims Act Yields $500,000 Settlement by Ambulance Company

              As a Tennessee False Claims Act attorney, I am pleased to report that First Call Ambulance Services paid $500,000 in May 2014 to settle a Tennessee False Claims Act lawsuit, alleging improper billing by the medical transport company. The undisclosed whistleblower is allowed to receive up to 30 percent of the amount in recognition of his initiative that led to a fraud investigation by federal and state authorities and recovery of Medicaid funds. The qui tam lawsuit is the latest in a series of hundreds of such whistleblower actions encouraged and protected under the Tennessee Medicaid False Claims Act, leading to reclaiming of embezzled taxpayers’ money running into millions of dollars.

              The Ambulance False Claims Act Lawsuit

              A Tennessee whistleblower approached the court accusing First Call Ambulance Services of upcoding and submitting false bills to claim money from state and federal Medicaid fund. According to the qui tam lawsuit filed as per the Tennessee Medicaid False Claims Act, First Call made fake claims claimed to have provided advanced life support to patients during medical transport to claim higher amounts while patients were provided much cheaper basic life support while on the ambulance. Our firm has successfully handled upcoding cases involving the Tennessee False Claims Act.

              A probe by the U.S. Attorney’s Office for the Middle District of Tennessee and the Tennessee Bureau of Investigation following the whistleblower false claim lawsuit found First Call guilty of submitting up-coded bills. The TN false claim act lawyer representing the submitted evidence to highlight that First Call billed many patients “who plainly did not need to be transported by ambulance or were able to walk to the vehicle and enter unassisted” for advanced life supports.

              While advanced life support was not offered in most cases as claimed and only basic life support was administered. There are many instances where extensive resuscitation efforts was claimed to be provided to patients, who did not have any kind of require life support on their way to hospital. Advanced life support involves extensive medical care and resuscitation efforts and hence is more expensive than basic life support services.

              Tennessee False Claims Act: What is Upcoding

              Upcoding refers to making a misleading claim for reimbursement for medical services more expensive than those performed. Each medical procedure has been assigned current procedural terminology or a code, which was quoted in the bill by healthcare provider and professionals when submitted for Medicaid or insurance reimbursement. When bills are submitted, higher or lower amount of payment is done based on these codes.

              Many seeking reimbursements make fraudulent claims by mentioning codes of higher-paying care than those actually rendered. There may be a bill mentioning code for ultrasound or MRI, the actual service was just a quick check up.

              A Tennessee False Claim Act Lawsuit

              Tennessee Medicaid False Claims Act recognizes upcoding as one of the fraudulent practices punishable with monetary penalty. Anyone found involved in submitting up coded bills is likely to be fined three times of the money embezzled along with $25,000 in penalty. The Medicaid False Claims Act rewards whistleblowers filing qui tam lawsuits with up to 30 percent of the total money recovered from the accused.

              Healthcare false billing and upcoding are common occurrences addressed by the Tennessee False Claims Act. If you have any evidence to expose any such fraud, contact an expert False Claims Act attorney to discuss your options whistleblower or qui tam actions.

              To Contact a Tennessee False Claims Act Today

              We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

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                Hospiutal Settled Tennessee False Claims Act Lawsuit for $9,250,000.00

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                Tennessee False Claims Act Settlement

                As a Tennessee False Claims Act lawyer, I am very pleased to report that CRC Health has agreed to pay $9.25 million ($9,250,000.00) to settle claims brought against it under the necessary provisions of the Tennessee Medicaid False Claims Act. A former employee of the group, a subsidiary of Bain Capital, had accused one of its addiction treatment facilities in Tennessee of defrauding the Medicaid money by making false claims for reimbursement and offering substandard services to inmates. Angela Cederoth, the whistleblower, is set to receive compensation amounting to $1.25 million for his role in helping the recovery of misappropriated TennCare funds.

                According to the whistleblower, New Life Lodge Facility, a substance abuse treatment and rehab center run by CRC Health in Burns, misappropriated millions of dollars between 2006 and 2012 by not providing assured minimum standard of substance abuse therapy. The hospital did not engage well-trained and licensed therapists to treat addiction patients at the hospital to ensure maximum profit. Most of the employees tasked with taking care of inmates were not qualified as per the Tennessee law.

                The principle of “medical necessity” was violated with failure to have

                “New Life Lodge accepted millions of dollars of TennCare funds with the understanding that it would provide necessary substance abuse treatment services to some of the State’s most vulnerable citizens, but far too often those operating the facility failed to meet their obligations by falling short of minimum necessary standards of care or using third-party pharmacies to double-bill the program,” alleges the TN Medicaid false claim lawsuit filed in against CRC Health.

                The facility was accused of engaging in double-billing to get higher payments from TennCare. It allowed admission of more patients than its stated capacity to ensure more profit, but failed to have the appropriate staff to patient ratio. Third-party pharmacies were roped in to make double billing for substance abuse medications and false bills were submitted for services not provided. Many of the services billed for were never documented.

                Of the $9.25 million settlement, the State of Tennessee is set to receive $3.4 million while the qui tam plaintiff is awarded a whopping $1.25 million for help in recovering state funds. The rest of the amount is to be deposited with the federal government.

                Tennessee Medicaid False Claims Act

                The Tennessee Medicaid False Claims Act enacted in 1993 allows necessary civil action by qui tam plaintiffs to highlight defrauding of TennCare funds and recover the conned money along with penalty. A TennCare fraud whistleblower can proceed with the state prosecution on his own with a qualified TN false claim attorney seeking return of the defrauded Medicaid funds on behalf of the state. He is assured of legal protection and financial award for his role in retrieving the public money.

                AIM Healthcare Services agreed to settle a litigation filed invoking the Tennessee Medicaid False Claims Act in February 2014. Accused of pocketing TennCare funds by making false bills, the group paid close to $800,000, of which the whistleblower received over $100,000 as reward.

                According to report, qui tam relators had helped state and federal governments to recover over $3 billion duped by false billing, upcoding, and other fraudulent practices in 2013. Of the 846 lawsuits filed last year, whistleblowers and their false claim attorneys played a vital role in 89 percent of litigations leading to retrieval of embezzled public money.

                To Contact a Tennessee False Claims Act Lawyer

                We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

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                  Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

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                  Tennessee Medicaid False Claims Act: Violations and Whistleblower Award

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                  FALSE CLAIMS FREE CASE EVALUATION: 1-800-632-1404

                  The Tennessee Medicaid False Claims Act came into existence in 1993. With the state legislature endorsing the legislation to split the Tennessee False Claims Act, a new law was enacted with exclusive focus on recovering embezzlement of healthcare funds. The older act with amendments continues to prevent fraudulent appropriation of state funds and punish perpetrators. In the recent years, the state has been able to recover millions of dollars defrauded through up-coding and false billing by many health service providers with more than a third of the recovered amount awarded to whistleblowers.

                  Tennessee Medicaid False Claims Act: The Coverage and Violations

                  Any fake claim made with an intention to get Medicaid reimbursements higher than the actual cost incurred is subject to recovery under Tennessee Medicaid False Claims Act. The provisions of the act cover TennCare funds and any other alternative Medicaid program succeeding the existing one.

                  Tennessee Medicaid False Claims Act considers the following types of actions as a violation of its provisions.

                  • Presenting false claims for payment from Medicaid funds
                  • Falsifying a record to seek a false Medicaid payment claim
                  • Involvement in conspiracy to defraud Medicaid money
                  • Avoiding or intentionally reducing obligation to pay any Medicaid-related amount to the state
                  • Acting in an ignorant manner despite being aware of false payments
                  • Disregard or deliberate ignorance of the false payment

                  Civil Action and Award to Whistleblowers

                  • The Tennessee Medicaid False Claims Act details the procedure for a civil action to be brought by a whistleblower or a quit tam plaintiff. A whistleblower should be an insider while any one can turn to be a quit tam relator seeking to recover state funds misappropriated. Your TN false claim lawyer should file a complaint under the act in camera and submit material evidence within 60 days. The defendant is notified of the false claim lawsuit only after the expiry of 60-day period.
                  • The state is free to join or reject a call to participate in any TN Medicaid false claim lawsuit and settle it with the concurrence of the court. The plaintiff can proceed alone and represented by his TN false claim lawyer when the state withdraws from the litigation.
                  • Compensation ranging from 15 to 25 percent of the recovered amount is granted to the whistleblower when state joins the prosecution. The compensation amount is enhanced between 25 and 30 percent of total settlements when the quit tam plaintiff proceeds with his own TN false claim lawyer and state does not participate in the process. The court can also ask the defendant to pay to the plaintiff any sum it thinks reasonable for the plaintiff to cover expenses incurred, legal costs, and attorney fees.

                  Tennessee Medicaid False Claims Act: Punishment and Recovery

                  A large number of Tennessee Medicaid false claim lawsuits have been filed in the last two decades citing embezzlement of state funds through upcoding, double billing, misleading medical procedures, fabricated medical test reports, phantom billing, submission of false claims, and such other practices. The Tennessee Medicaid False Claims Act provides for tough penalty and imposes economic damages to punish those involved in such practices.

                  The act seeks to recover thrice the damages to the state exchequer from the individual found guilty of making misleading Medicaid claims. An additional civil penalty ranging from $5,000 to $25,000 is also imposed on the defendant.

                  As a goodwill gesture, the Tennessee Medicaid False Claims Act empowers the court to reduce the recovery to twice the money defrauded, if the defendant fully cooperates with the investigation and furnishes the full details of false claim payments within 30 days.

                  FOR FALSE CLAIMS ACT HELP, PLEASE CONTACT US.

                  We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today, or visit our False Claims Act Litigation Source.

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                    Tennessee False Claims Act: A Brief Overview

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                    FALSE CLAIMS FREE CASE EVALUATION: 1-800-632-1404

                    The Tennessee False Claim Act was enacted as an offshoot of the Federal False Claim Act signed into law in March 1863 and subsequently amended in 1986. The act lays down the fundamental basis for whistleblower lawsuits to highlight fraud committed against the government through false claims and to recover damages and penalties. In 1993, a separate Tennessee Medicaid False Claims Act was enacted to recover defrauded Medicaid or state healthcare money.

                    The original Tennessee False Claim Act was expanded in 2001 to cover all types of liability arising out of defrauds committed against the state. In 2012, the act was further amended to accommodate broad changes introduced through the federal legislation in 2009 and 2010.

                    Application of Tennessee False Claim Act

                    The Tennessee False Claim Act is applicable to any “deliberate or knowingly false or fraudulent claim to the government for payment or approval” within the state. According to legal provisions, “any false or fraudulent conduct, representation, or practice in order to procure anything of value directly or indirectly from the state or any political subdivision” imposes a liability to be prosecuted.

                    Any individual, company, association, organization, trust, business, or partnership incurs liability under the act for receiving state money, property, or service by making false claims.

                    Tennessee False Claim Act: Types of Fraud Covered

                    The following four types of frauds committed against the government result in liability under the Tennessee False Claim Act.

                    • Knowingly making a false claim for payment
                    • Using a false record to put a claim for payment
                    • Party to conspiracy to get a fraudulent claim approved
                    • Knowingly covering up, avoiding, or reducing the obligation to pay

                    In the last few years, a number of whistleblower lawsuits invoking the Tennessee False Claim Act have been filed in the state for

                    • Dishonest marketing practices by medical device manufacturers
                    • Wrong marketing and kickbacks to sale prescription drug
                    • Double billing
                    • Submitting false bills
                    • Supplying untested or inferior equipment
                    • Inappropriate medical procedure to seek higher reimbursement
                    • Defective testing or misleading test information
                    • Misrepresenting real values or hiding info
                    • Doctored records to show fictitious natural resource production
                    • Bribery to win kickback to get contracts or services
                    • Phantom billing

                    The Principle of Qui Tam

                    The principle of qui tam is an essential part of the Tennessee False Claim Act. It empowers any one to turn a whistleblower against his or her employer and file litigations against actions defrauding the government. Whistleblowers are awarded between 15 and 30 percent of the total settlement.

                    The act used the term “relator” in place of whistleblowers to allow any private person to file and pursue litigations on behalf of the state under the Tennessee False Claim Act.

                    Penalty and Damages

                    According to the Tennessee False Claim Act, a relator can file lawsuits when there is a fraud involving more than $500. It also specifies three types of penalties to be collected through civil action. A three-time penalty of the total amount of loss to the exchequer plus a civil penalty of at least $2,500 and the maximum of $10,000 is imposed for

                    • making false claim for approval or payment
                    • making or using doctored records for approval or payment
                    • involved in conspiracy to defraud the government
                    • making reduced disbursement of public money
                    • delivering false receipts
                    • illegal buying of debt or public property
                    • concealing money to be paid to the state
                    • being beneficiary of a false claim
                    • encouraging fraudulent practice

                    The court is empowered by the Tennessee False Claim Act to impose a penalty amounting to at least twice and a maximum of three times of the amount of damages incurred by the state without any penalty, if the person or organization responsible for fraud willingly cooperate with investigators and submit all necessary information within 30 days of the wrong committed and prior to any civil or criminal action is initiated.

                    Whistleblower Protection

                    TheTennessee False Claim Act provides for legal and financial security of whistleblowers. It even allows a realtor to proceed with the litigation through his own attorney and as the full party, if the prosecuting authority declines to go forward.

                    A part of the damages and penalties collected is awarded to the realtor, including between 15-25 percent of the total recovery depending on the amount of assistance provided by the relator. In some limited circumstances, a relator can be prohibited from recovery or receive less than 15%.

                    TheTennessee False Claim Act also prohibits an employer from “discharging, demoting, suspending, threatening, harassing, denying promotion, or discriminating in any manner against an employee for disclosing or furthering a false claims action.” The employer have to face penalty, such as payment of twice the back pay with interest and punitive compensation along with lawyer’s fee for violating the above stated protection guarantee under the false claim act.

                    Statute of Limitations

                    Any litigation filed under the Tennessee False Claim Act is subject to three-year statute of limitations from the date of discovery by state officials. It must be brought within 10 years of the act committed.

                    FOR FALSE CLAIMS ACT HELP, PLEASE CONTACT US.

                    We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today, or visit our False Claims Act Litigation Source.

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                      Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.