Being charged with fraud by any government agency is a very serious legal issue that must be dealt with by strongly defending the claim of the government. Sometimes the charging agency actually has a solid case against an investigation target, but many times they also attempt to prosecute individuals on flimsy or inadmissible evidence that can be dismissed from consideration by an experienced and aggressive New York City criminal defense attorney who understands the weaknesses in a prosecution case. The government is not entitled to a conviction, and they must still prove beyond a reasonable doubt that their assertions are factual and have been acquired according to constitutional protocol. Just because the government makes a claim does not mean it is solid enough to warrant a criminal charge. This is often the central issue in a false claims charge when the only evidence is part of an information trail with no official verifiable testimony from particular individuals who can potentially present material evidence in the charge.
What is the False Claims Act
Government fraud cases are normally prosecuted under the False Claims Act that was enacted during the Civil war. Commonly known as the Lincoln Law, it was focused on false billing claims submitted to the United States government during the Civil War for specific goods and services. That legislation is still used today, and it allows for specific whistleblowers, legally termed as relators, to provide testimony and direction to physical evidence that can be the basis of a False Claims Act charge. In addition, these relators are often given legal standing to sue in connection with the investigation and prosecution, potentially sharing in the proceeds recovered by the government. Having an experienced former prosecutor representing your case means that you have your own legal team who understands what is necessary to establish a valid charge and will be working diligently to discount any questionable evidence establishing criminal intent.
The False Claims Act is being used more so in contemporary cases since the establishment of the Affordable Healthcare Act that has sent many new insured patients to the doctor. Depending on the case factors, many times the case can be a civil inquiry into potential problems found by the particular government billing oversight agency. However, the government maintains thousands of contracts with private sector entities that rely on government financial payment that is transmitted digitally on a regular basis. Even missing a billing code change can result in questionable billing entries. Errors in billing are very common when potential fraud cases are evaluated, and often they are the result of continued systemic errors in the billing process. Investigations are civil until the point where criminal intent is possible, and restitution is often the actual legal remedy. This is exactly what a thorough New York City criminal defense attorney will be addressing concerning governmental evidence in the potential charge. In addition, if the relator is attempting to sue the investigation suspect, their testimony could easily be eliminated when billing mistakes can be categorized as human error. Intent is vital for an investigation to move to a criminal consideration.
Defending Criminal Charges
Many times the Department of Justice will want to pursue criminal charges against a defendant when they think they have solid case for prosecution. Penalties for conviction in a False Claims Act can be extensive, especially with respect to potential fines. In November of 2015 the government increased the fine range to $10,000-21,000 for egregious cases, but still has the authority to lessen a fine dramatically when intent is minimal. Continual minor billing problems could easily result in an investigation, and many times the conflict comes down to ineffective communication. Without a comprehensive New York City criminal defense lawyer it could be easy to receive a significantly higher fine than the case would warrant based on material case factors. The “materiality” of the claims by the DOJ is the basis for any successful prosecution. Just because the prosecution introduces an article of evidence does not necessarily mean it is a material case factor, and an experienced former prosecutorunderstands when evidence can be questioned and dismissed.