The United States Government has continually and steadily ratcheted up its efforts in conducting False Claims Act (FCA) investigations, and seeking sizeable recovery amounts through both judgments and settlements. During the 2015 Fiscal Year (FY), the Department of Justice (DOJ) recovered $3.5 billion in settlements and judgments in civil cases involving fraud and false claims against the United States Government – $1.9 million of which was attributable to alleged FCA violations in the healthcare space.
These numbers demonstrate that combatting healthcare fraud is quickly rising in its level of significance and the level of attention it is paid. Combatting healthcare fraud has been recognized as a top priority by the Obama Administration and classified as second in import only to prosecuting violent crime by the Federal government. This trend was recently expanded in the compounding pharmacy space. Indeed, while FCA investigations seemed to be generally initiated out of, and conducted by, districts within a single State for several months, we are now seeing a multitude of other States coming to the table to both initiate, and participate in, investigations of compounding pharmacies and related entities.
Investigations related to violations of the False Claims Act are generally pursued utilizing a tool known as a Civil Investigative Demand (CID), which is a type of administrative subpoena. A CID may issue merely on the Government’s showing that it has “reason to believe” a CID’s recipient may be in possession, custody, or control of documents or information relevant to a False Claims Act investigation.
Because CIDs can issue prior to the Government’s official opening of a case, the Government is able to probe and pry into providers’ billing mechanisms, collections of copayments and marketing practices, among other operational systems, without furnishing the provider with the reciprocal ability to conduct its own discovery. When coupling this expansive ability with the extremely low burden which must be met to issue a CID, the Government is provided an immeasurable unilateral advantage above the witnesses, subjects, and targets of its investigations. This proves to be even more daunting when examined against the backdrop of the increasingly expansive healthcare investigations.
Frier Levitt has handled countless investigations related to alleged violations of the False Claims Act at both State- and Federal levels. If you’ve been issued a CID or are aware of any pending investigation against you, it is time you act to your advantage. Contact Frier Levitt today.
