False Claims Act

The stakes for health care providers, government contractors, and other businesses and individuals accused of seeking payment or reimbursement from the government to which they are not entitled (often based on alleged violations of arcane health care and government procurement statutes and regulations) are high. The consequences can include treble damages, punitive monetary penalties, exclusion from government programs, and sometimes criminal sanctions. We frequently defend our clients against allegations brought under the U.S. Department of Justice’s government weapon of choice in these cases—the False Claims Act (FCA)—including the qui tam provisions, which entice whistleblowers, referred to as relators, to file suit on behalf of the government in exchange for significant monetary rewards of up to 30 percent of recovered funds.

Drawing upon robust experience in government—as former prosecutors and government officials—and before the courts that are most active in FCA-related matters, we serve as counsel in investigations and proceedings brought against our clients by the DOJ in conjunction with the Inspectors General of HHS, DOD, other federal agencies, and state attorneys general under state false claims acts. We steer clients through the complex web of criminal, civil, and administrative concerns as well as the business considerations implicated in these investigations and prosecutions.

We take pride in our ability to protect our clients’ legal interests while working to minimize business disruption, safeguard reputations, and preserve good will. Zuckerman Spaeder attorneys often persuade government lawyers not to pursue these cases or to resolve them before trial. If litigation is unavoidable, our clients benefit from our team of seasoned trial lawyers—a hallmark of our firm.

Our successes for clients includes avoiding prosecution and intervention in civil FCA actions; securing dismissal of civil actions that the government or qui tam relators have pursued; obtaining numerous acquittals, in one case, after a months-long trial; negotiating deferred prosecution agreements and favorable settlements; obtaining declinations; and preserving our wins on appeal. Perhaps most critical for health care providers and government contractors, we work tirelessly to maintain our clients’ eligibility to do business with the government.

Civil Investigations and Litigation

Any person or entity who is paid or reimbursed from federal funds is at risk of FCA liability. A relator can second-guess subjective judgments made by professionals, physicians, hospitals, and other healthcare providers, by filing suit alleging that they are seeking reimbursement for unnecessary medical procedures, or that they are paying or receiving more than fair market value for goods or services. Similarly, health care providers’ routine business transactions can be challenged using the FCA as a vehicle to pursue civil remedies for violations of the federal Anti-Kickback Statute and its byzantine regulations. Other complex health care laws and regulations can leave the door open for misinterpretation. We zealously advance our clients’ legal interests and at the same time strive to protect their core businesses and reputations. Our attorneys understand the intricacies of these issues and stay abreast of changes in laws and regulations related to health care law and government procurement and reimbursement. 

When Zuckerman Spaeder clients receive civil investigative demands (CIDs) or Office of Inspector General (OIG) subpoenas, our attorneys understand the importance of promptly determining the focus of the government’s investigation. They have extensive investigative experience and know how to conduct a thorough internal investigation to ensure that we understand the facts better than the government will and can stay several steps ahead. We know when it is in our clients’ interest best to make a presentation to government lawyers to dissuade them from intervening in the relator’s lawsuit or when another approach is preferable. We are equally adept at positioning our clients for a vigorous defense if the government intervenes or if the relator pursues the case. By the time a complaint is unsealed—often several years later—we ensure the best possible result for our client.     

White Collar Investigations and Prosecutions

If a False Claims Act investigation leads to a grand jury investigation, or even an indictment, aggressive prosecutors seek to prove that a company or individual knowingly submitted false or fraudulent claims to the government, retained overpayments, or violated other laws, such as the Anti-Kickback Statute (AKS). With significant financial penalties, exclusion from government programs, and potential prison time at stake, it is important to have counsel with experience handling similar white collar cases. 

We understand the impact these investigations have on our clients’ day-to-day commercial and professional activities. We account for these factors in seeking resolutions that can achieve our clients’ goals and objectives. As a preeminent white collar defense and investigations boutiques, our clients rely on us when it matters most.