Myths About the False Claims Act in Texas

 Posted on January 09, 2024 in Uncategorized

The Federal False Claims Act and Texas Medicaid Fraud Prevention Act aim to combat fraud against the government stemming from false reimbursement claims for products and services not actually provided. These whistleblower statutes hold perpetrators liable through civil penalties and triple damages. However, common misconceptions confuse the FCA/TMFPA among would-be relators initiating fraud suits. A Texas False Claims Act lawyer can help you navigate a charge for a false claim.

Myth #1 - Most Claims Require Explicit Intent to Defraud

Cases do not require proving deliberate intent to obtain payments wrongly. Acts committed in “deliberate ignorance” or “reckless disregard” for truth and falsity also break FCA/TMFPA laws. Even unintentional submitting of false certifications or statements violating requirements attaches liability if underlying actions show extreme carelessness or buried heads.

Myth #2 - Violations Must Involve Federal Funds

While the Federal False Claims Act covers fraud against federal programs like Medicare or defense contracts, the TMFPA specifically addresses deceit involving Texas Medicaid funds. So, fraudulent claims do not necessarily need federal money involvement to violate provisions and face penalties. State taxpayers suffer, too.

Myth #3 - Only Large Healthcare Companies Get Targeted

While big pharmaceutical and device makers grab headlines, small healthcare businesses, including hospitals, clinics, hospices, testing labs, and individual doctors, frequently face charges. Any medical provider of any size knowingly overbilling programs or paying illegal kickbacks faces liability regardless of revenues or staff size.

Myth #4 - Relators Must Have Strong Proof Before Filing

The laws allow whistleblowers documenting reasonable suspicions of violations to file initial complaints “under seal” while government investigators assess merits confidentially first. Relators do not need irrefutable proof up front when first filing a complaint. To file a complaint, relators need to lay out a clear explanation of how fraud is happening, along with some example claims that look questionable.

Myth #5 - Relators Always Get Huge Percentages of Recoveries

By law, those who initiate valid fraud cases via filed complaints and provide supporting evidence earn 15-30% of the amount the defendant pays in judgments or settlements. However, the ultimate reward depends on the contribution level, analyzing factors like relevance, credibility, and timeliness of evidence provided throughout the case lifecycle. Paydays align accordingly.

Contact a Dallas, TX False Claims Act Lawyer

If you are facing a charge for a false claim, having legal representation may help. You should avoid navigating a situation like this on your own. With a Dallas, TX False Claims Act attorney, you can understand which steps may be best at certain times for your situation. Call Spencer & Associates at 214-385-8500 for a free consultation.