Being in the healthcare industry is about more than just financial gain; it carries significant ethical responsibilities to protect your patients and uphold the reputation of your practice. Disregarding California law or engaging in fraudulent practices can have serious consequences that not only harm your patients but also jeopardize your professional reputation and the integrity of your practice.
The False Claims Act (California) is one law put in place to prevent fraud in government healthcare programs. Violations can lead to False Claims Act fines, exclusion from government programs, and damage to both personal and professional reputations.
Healthcare providers facing False Claims Act investigations need to take them seriously, as the implications can be far-reaching. Experienced False Claims Act attorneys can help you navigate these investigations and protect your practice against future claims of fraud.
The False Claims Act is a legal framework designed to prevent and address fraudulent claims for money, property, or services submitted to state or local governments, such as a healthcare program like Medicare or Medi-Cal.
Under California Government Code Section 12650, a claim is considered fraudulent if the person submitting it knows it is false, deliberately ignores the truth, or recklessly disregards the truth.
The false information must also be material, meaning it is significant enough to influence the government’s decision to pay or provide resources. Local government officials, such as county counsels or city attorneys, are authorized to investigate and prosecute these fraudulent claims to ensure accurate billing and protect public healthcare funds.
Engaging in intentional fraudulent practices can trigger serious investigations under the False Claims Act. Common examples include:
These fraudulent activities can lead to serious consequences, including increased health insurance premiums, compromised patient safety, and higher taxes. Such practices not only harm the financial stability of healthcare programs but also endanger patients and undermine trust in the healthcare system.
If your healthcare practice is under investigation for potential violations of the (California) False Claims Act, it is important to take immediate action to protect your practice and reputation. The first step is to consult experienced False Claims Act lawyers. They will be able to guide you through the investigation, help you understand your rights, and develop a defense strategy.
It is essential to preserve and organize all relevant documentation, including billing records, patient files, and communication logs, as this will serve as evidence to demonstrate compliance with legal requirements. Cooperation with investigators is also crucial — providing requested information and respecting the process can positively influence the outcome.
Additionally, consider conducting an internal audit of your billing and documentation practices to identify and address areas of concern. This will help show your commitment to compliance and help the team take corrective actions in the future.
To minimize the risk of future investigations, focus on strengthening your compliance programs. Develop clear policies and regularly update procedures to align with current legal standards. Training and educating your staff on compliance protocols and the importance of accurate billing practices are key to reducing errors.
Fenton Jurkowitz Law Group has a team of seasoned attorneys who can assist you in False Claims Act investigations and ensure your rights are fully protected. Fill out our contact form on our website to connect with a healthcare practice attorney today.