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The plaintiff or “relator” must provide the Department of Justice with a copy of the complaint and a written disclosure of all material evidence and information known to the relator.
Knowingly means 1) having knowledge 2) acting in deliberate ignorance of the truth or falsity of the information, or (3) acting in reckless disregard of the truth or falsity of the information. Right: Engraving of the immigrant scene at Ellis Island, New York harbor. The Department of Justice is investigating radiation oncology service providers. In the words of the infamous American bank robber Willie Sutton, “because that’s where the money is.” Last year, the Centers for Medicare & Medicaid Services (CMS) disclosed the amounts paid to physicians, and radiation oncologists were among the top recipients of federal monies.This article provides an overview of the federal False Claims Act and discusses specific legal actions pursued against radiation oncology providers under the False Claims Act, either by the Department of Justice, a relator (one who brings an action on the government’s behalf), or both.Most importantly, it examines the specific misconduct identified as actionable, and highlights common sense practices to avoid being named as a False Claims Act defendant, particularly when developing cost-containment strategies.Several states have enacted their own versions of the federal civil False Claims Act as well.
Under the provision of the False Claims Act, a private person may bring a civil action on behalf of the United States.
Deliberate ignorance requires proving that a provider would have had reason to believe its actions may have been unlawful and that the providers purposely failed to investigate any suspicions.
In determining whether there was reckless disregard, courts have considered “clumsiness,” “carelessness and foolishness in the extreme,” “lack of slight diligence or care” and “omission in reckless disregard of a legal duty.” The False Claims Act has been used in a variety of contexts against government contractors, Medicare providers, real estate developers, and other providers of goods and services procured by the federal government.
Also, penalties may be assessed even when there is no proof of damage to the United States.
In general, liability under the False Claims Act extends to deliberate ignorance and reckless disregard of the truth or falsity of information pertaining to claims for government funds.
Third, it can notify the court that it declines to intervene, permitting the relator to conduct the action in place of the government.