Fraud Reimbursement

The Ohio Attorney General announced that a $26 million dollar settlement with a company called Care Source, which is a managed health care company. The settlement involved allegations of Medicaid fraud by the company. As a part of the settlement, two people who initially reported the fraud will share in a part of $3 million dollars receive by the Federal Government.

If someone turns in a person or company for cheating the Federal Government, can they receive some of the money?

In certain situations, yes. Under the Federal False Claims Act, if someone knows of a fraud against the U.S. Government, they can sue on behalf of the government and receive between 15-30% of the funds recovered. For example, a recent settlement agains a pharmacy comapny annouced by the U.S. Government resulted in five (5) whistleblowers dividinng approximately $40 million dollars as their share of the settlement.

What sort of claims are allowed?

The list is unending, but here are some examples:
- Overbilling for medical services;
- Overbilling for prescriptions, such as billing for brand name drugs when generic draugs are actually provided;
- Double billing for supplies to the government;
- Winning a contract through kickbacks or bribes

According to the Taxpayers Against Fraud Education Fund, the Federal Government has received more than $3 billion in settlement recoveries from false claims lawsuits, with 80% coming from the health care industry. However, even something like education has been caught. The University of Phoenix settled a $67 millions dollar claim that they paid college counselors to send students to the school.

Why did Congress pass the False Claims Act?

The idea is that the Federal Government just cannot police all of the fraud out there. By providing an economic incentive for individuals, it is hoped that private individuals will help the government catch the crooks.

Does Ohio have such a law?

Presently, there are 28 states that do have laws similar to the Federal Law, but Ohio currently does not have the equivalent of the Federal False Claims Act. If you think you know of a fraud being committed against the Federal Government, you should contact an attorney. You can also go to www.taf.org, which is the Taxpayers Against Fraud Education Fund to start your initial research into the field.

No Comments

Leave a comment
Comment Information

Office Location

Independence Office
6100 Oaktree Blvd.
Suite #200 - Park Centre 1
Independence, OH 44131

Toll Free: 888-236-5173
Phone: 216-765-0123
Fax: 216-595-2787
Map & Directions

Mayfield Heights Office
6105 Parkland Boulevard, Suite 140
Mayfield Heights, OH 44124

Toll Free: 888-236-5173
Phone: 216-765-0123
Fax: 216-595-2787
Mayfield Heights Law Office Map

Westlake Office
159 Crocker Park Boulevard
4th Floor
Westlake, OH 44145

Toll Free: 888-236-5173
Phone: 216-765-0123
Fax: 216-595-2787
Map & Directions

2005 BBB Torch Award Recipient Recipients of the 2005 BBB Torch Award Honoring Business of Integrity

  • Charter Member Elder care matters Alliance
  • National Academy of Elder law attorneys Inc. Member
  • ASNP
  • Cleveland Metropolitan Bar Association | CMBA Green Certified 2015-17
  • Listed On Elder case Websites