White Collar Defense, Internal Investigations, & Regulatory Compliance

False Claims Act Investigations & Whistleblowers

Defense in government investigations and civil qui tam litigation under the False Claims Act.

Overview

The False Claims Act is the federal government's primary weapon against fraud involving federal funds: Medicare, Medicaid, defense contracts, federal grants, and virtually any program involving federal money. It authorizes damages of three times the false claims amount plus per-claim penalties, and its qui tam provisions allow whistleblowers to file suit on the government's behalf and collect a share of any recovery.

Daniel Fridman's representation of a U.S. state agency in a DOJ False Claims Act investigation reflects the full range of our FCA practice. The DOJ Civil Division alleged the agency had introduced bias into a federal benefits program's quality-control process, resulting in false quality-control data and unentitled performance bonuses. The government's demand exceeded $40 million, reflecting the treble damages and per-claim civil penalties available under the FCA; the matter resolved for $17.5 million, a fraction of the government's original demand (DOJ Press Release No. 21-647, July 12, 2021). We represent companies and individuals at every stage: responding to Civil Investigative Demands, negotiating with the DOJ Civil Division, defending in qui tam litigation after government intervention, and litigating in cases where the government declines but the relator pursues independently.

Our Approach

The most important window in any FCA investigation is before the government decides whether to intervene in a qui tam suit. During the investigation period, which can last years while the complaint is under seal, companies can present their business practices, demonstrate compliance, and argue for non-intervention or favorable resolution. We engage DOJ Civil Division attorneys during that window and build the record that makes a declination or favorable settlement achievable.

Representative Experience

White Collar & Government Investigations

  • False Claims Act Defense of a U.S. State Government Agency

    Selected through a competitive process as lead counsel for a U.S. state agency in a DOJ Civil Division False Claims Act investigation over alleged quality-control fraud in a federal benefits program. The government's demand exceeded $40 million, reflecting the treble damages and per-claim civil penalties available under the FCA. Resolved for $17.5 million, a fraction of the government's original demand; Mr. Fridman signed the settlement on the agency's behalf.

Frequently Asked Questions

What is a qui tam lawsuit?

A qui tam lawsuit is filed under the False Claims Act by a private person (the relator) on behalf of the federal government. The complaint is filed under seal while the government investigates. The government can then intervene and take over prosecution, or decline and allow the relator to proceed. Relators who prevail receive 15-30% of the government's recovery. Defendants do not learn they have been sued until the seal is lifted.

What is a Civil Investigative Demand and what does it mean to receive one?

A CID is the DOJ's tool for compelling document production and testimony in an FCA investigation before any lawsuit is filed. Receiving a CID means the government is actively investigating whether your company submitted false claims. It can be a precursor to civil FCA litigation or a parallel criminal referral. Companies should retain experienced FCA defense counsel immediately.

We discovered a billing error that resulted in Medicare overpayments. Is there a mandatory repayment deadline?

Yes. Under the False Claims Act, a provider that has identified (or 'identified and quantified') an overpayment must report and return it within 60 days. This is the so-called '60-day rule.' Retaining an overpayment after it has been identified and quantified is itself a false claim. The government has argued successfully that failing to report and return constitutes a reverse false claim, carrying the same treble damages exposure as submitting a false claim in the first instance. The clock-start question, when an overpayment has been 'identified,' is a critical issue. There is regulatory guidance defining 'identified,' but the line between investigation and identification is actively contested. If you discover a potential overpayment, retain experienced FCA defense counsel immediately to assess the 60-day timeline and your disclosure obligations before that window closes.

Team

Facing a government investigation?

Time matters. Contact us before the first interview request.

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