Florida Fraud & Whistleblower Lawyers
At McCabe Rabin in West Palm Beach, you will find a team of excellent and creative litigators who have litigated against the big national and local law firms and obtained successful results. As a boutique litigation firm, we take the time to get to know our clients so that we can be responsive to their needs and bring about a value-driven resolution that protects their rights and meets their needs. Our Florida fraud & whistleblower lawyers handle a wide variety of legal matters in West Palm Beach, throughout Florida and beyond. We focus our attention on providing excellent client service, defining a plan to accomplish client objectives, and representing clients’ interests aggressively and ethically.
What is Fraud?
While most of us have heard about fraud, many are unaware of what it actually encompasses. Fraud is a legal term that refers to the use of intentional deception or dishonesty to obtain an unauthorized benefit. While there are both state and federal laws in place that aim to protect people from being taken advantage of in this way, thousands of individuals still find themselves the victims of fraud everyday. Fortunately, it is possible to hold companies and individuals accountable for their use of deceptive or dishonest tactics, so if you were the victim of a fraudulent act, it is important to reach out to an experienced Florida fraud lawyer who can help you seek compensation for your losses.
Types of Fraud
There are a number of different types of fraud, but the most common include:
- Medicare/Medicaid fraud, which occurs when a healthcare provider bills for services that were not provided, charges for unnecessary services or treatment, or pays third parties for patient referrals;
- Military/government fraud, which consists of fraudulent acts in connection with obtaining a government contract, or in regards to federal programs like public housing;
- Embezzlement, which occurs when a person or entity misappropriates assets that were entrusted to them;
- Forgery, which involves the unlawful imitation of an object of value with the intent to deceive and includes offenses such as falsifying contracts or signing someone else’s name on a check;
- Fraudulent financial reporting, which involves intentionally misrepresenting a firm’s financial statements to give investors a false impression of the company’s performance and profitability;
- Identity theft, which involves the unauthorized use of a person’s identifying information for economic gain;
- Money laundering, or concealing the origins of funds obtained illegally through a sequence of transactions and banking transfers;
- Securities fraud, which occurs when an investor is induced to make purchase or sale decisions based on false information; and
- Mail fraud, which involves the use of the U.S. mails to perpetrate a crime of deceit.
Both state and federal law criminalize this type of conduct, so defendants who are convicted of fraud face serious penalties, including jail time, fines, and restitution.
Elements of Fraud
To prove that someone committed fraud, a plaintiff will need to provide a court with convincing proof that:
- The defendant purposely misrepresented a material fact despite knowing that the information was false or deceptive or otherwise intentionally misled the plaintiff;
- The plaintiff relied on the defendant’s misrepresentation; and
- The plaintiff suffered an actual loss as a result of that reliance.
The evidence needed to prove that these elements have been fulfilled can include everything from business records and financial documentation to testimony and complaint letters. Collecting this evidence can, however, be a complicated endeavor, so if you believe that you were the victim of fraud, please call our office to begin investigating your claim.
Reporting Florida Medicare Fraud
Medicare fraud is usually committed by medical practitioners, hospitals, and medical equipment suppliers that claim money from the Medicare program for services that they don’t actually provide. Although it is possible to file a claim against those who commit Medicare fraud, doing so can be difficult, so if you have questions about filing a lawsuit against a healthcare provider or hospital for Medicare fraud, please contact an experienced Florida medicare fraud lawyer today.
What is Medicare Fraud?
Medicare fraud can take a number of different forms, but most often involves:
- Upcoding, which occurs when a healthcare provider bills at a higher code than is permitted;
- Billing for services that aren’t necessary or weren’t even provided;
- Unbundling services, which occurs when a provider submits separate bills for lab services that should actually be billed as a single group;
- Billing non-covered services as covered services; and
- Soliciting, offering, or receiving a kickback in exchange for a referral.
While some hospitals and healthcare providers use these same methods against insurance companies, the reward program authorized by the False Claims Act only issues monetary awards for reports of fraud committed against Medicare programs. This means that if a hospital was upcoding for most of its patients, the reward program would only issue compensation based on the fraud committed specifically against Medicare recipients.
Filing a Whistleblower Complaint
Whistleblowers who have knowledge of Medicare fraud can file a complaint under the False Claims Act, which rewards whistleblowers with between 15 and 30 percent of what the government collects from the at-fault provider. However, to receive a reward, a complainant must hire an attorney to file a lawsuit against the at-fault party. The complaining party will also need to provide the government with details and specific evidence of the fraudulent act. Rewards are collected most often by those who work for the hospital or healthcare provider who committed the fraud.
How to Report Medicare Fraud
Whistleblowers who report Medicare fraud must file a qui tam application under the False Claims Act with the aid of an attorney that contains detailed evidence of the fraudulent activity in question. It’s important to note that while the Office of Inspector General does accept complaints regarding Medicare fraud, they do not provide the complainant with a reward. Instead, whistleblowers should file a complaint directly with a federal district court, which will keep the case “under seal” until the government has completed an investigation, at which point, it will decide whether or not to intervene in the case. If successful, a complainant could receive a reward of between 15 and 25 percent of the amount recovered by the government.
Whistleblower Cases (Qui Tam Cases)
Every year, the U.S. Government spends billions of dollars on government loans, grants, and contracts for goods and services. About 10% of this amount, however, is lost due to fraud. This is a staggering amount of losses to the Government, measuring in the hundreds of millions of dollars. The government wants to recover this money, but they need your help and are willing to pay for it.
- Pharmaceutical/Health Care Fraud
- Medicare/Medicaid Fraud
- Overbilling Medicare/Medicaid
- IRS Fraud/Tax Evasion
- TARP Funds Fraud
- Failing to pay overtime benefits when they are due
- Government Fraud
- Defense Contract Overcharging
- Aerospace Contract Overcharging
We will guide you through the process of filing an action under the federal False Claims Act and provide representation throughout the course of the litigation, whether your participation is limited to supporting the Government or if you are put in the role of taking the lead in prosecuting a claim on the Government’s behalf.
Our Florida whistleblower law firm is national in scope and results. If you are aware of significant Government fraud anywhere in the United States, we want to help you.
We also handle cases arising under the Florida False Claims Act and other laws that protect state and local governments against fraud.
Florida False Claims Act
The federal government recovers billions of dollars in fraudulent billings and overpayments every year under the False Claims Act, which allows private persons to blow the whistle and bring lawsuits on behalf of the government. Yet it is not only the federal government which is constantly being defrauded. The state of Florida has its own False Claims Act mirroring the federal law and providing a way for individuals to sue and help recover fraud against Florida state government entities. The attorneys at McCabe Rabin are authorities on the Florida False Claims Act. Read on for more information about this important state law, and contact McCabe Rabin for assistance in a Florida False Claims Act whistleblower case.
The Florida False Claims Act (FFCA) can be found in Florida statutes sections 68.081 through 68.092. This law prohibits false or fraudulent claims made to or paid by the “state.” Although originally only applying to executive agencies of the state government, amendments were made to the law so that now “state” is defined more broadly.
Illegal Acts under the FFCA
The FFCA prohibits persons and companies who do business with the state from engaging in many different types of fraudulent activity, including the following (among others):
- Knowingly presenting a false or fraudulent claim for payment or approval
- Knowingly making or using false records or statements material to a false or fraudulent claim
- Knowingly making or using false records or statements material to an obligation to pay or transmit money or property to the state
- Knowingly concealing or knowingly and improperly avoiding or decreasing an obligation to pay or transmit money or property to the state
- Conspiring to do any of the above
In making a false claim, the claim does not always have to be made directly to the government. For instance, a subcontractor could present a false claim to the general contractor, knowing that the subcontractor will be paid with government money. The subcontractor in this instance is guilty of violating the FFCA. Similarly, a subcontractor violates the FFCA when intending to defraud the general contractor on a government contract; intent to defraud the government directly is not required.
Penalties for Violating the FFCA
Those found in violation of the FFCA can be liable to the government for a statutory fine between $5,500 and $11,000 per violation, along with treble damages, or three times the amount of actual financial loss caused to the government.
Procedure for Blowing the Whistle and Filing a Lawsuit under the FFCA
If you are a whistleblower with knowledge of a Florida False Claims Act violation, the first step is to hire a lawyer who knows how to bring a whistleblower case. The lawyer will help you notify the Florida Attorney General and/or the Chief Financial Officer (CFO) of the alleged misconduct. All material evidence and information should be disclosed at this time. A sealed complaint is filed in the Second Judicial Circuit court in Leon County, and the AG or CFO has 60 days to review the matter and decide whether or not to intervene.
If the state intervenes and prosecutes the violator, the whistleblower (also known as the relator) will receive 15 to 25% of any award recovered, depending upon the level of the relator’s participation in the action.
If the state declines to intervene, the relator can pursue the matter on behalf of the government. In this case, the relator will receive 25-30% of any award. This amount can be reduced if the relator was also somehow involved in planning or initiating the wrongful conduct.
Our Florida Board Certified Business Litigators represent your interests expertly and efficiently in complex business disputes. While we strive to resolve disputes in the most efficient and business-like manner possible, we are litigators who are willing and able to try cases and take a matter before a judge, jury, or arbitrators whenever it is in our client’s best interests to do so. Trial experience matters. Call on McCabe Rabin in West Palm Beach for an efficient, effective and favorable resolution of your business dispute.
Securities Arbitration & Litigation
You work hard for your money and invest for your future. Losing your hard-earned savings due to unsuitable recommendations from a financial advisor. But, there is something you can do about it. We have the knowledge, skills and experience to determine whether your broker recommended unsuitable investments, overconcentrated your portfolio in a particular stock or asset class, or engaged in unacceptable conduct such as churning or omitting important information when giving investment advice. Our firm is experienced in the specialized area of securities arbitration before the Financial Industry Regulatory Authority (FINRA) and litigation under the Florida Securities Investor Protection Act (Chapter 517, Florida Statutes). We can help you recover your losses and other financial damage caused by broker misconduct or companies committing securities fraud.
Our Florida Litigation Team is Eager to Help You
Call McCabe Rabin in West Palm Beach to discuss your legal matter. We provide representation under a variety of fee structures, including reasonable hourly fee arrangements, contingency fee agreements in appropriate cases, and hybrid or mixed hourly and contingency fee structures. Call our Florida fraud & whistleblower/Qui Tam lawyers today or contact us online to schedule a consultation, and find out what our attorneys can do for you on your matter.