Optional_2023 Board Resources
from the relator, or decline to intervene, which permits the relator to continue to pursue the case on their own. 42 The government frequently obtains seal extensions to continue its investigation. If the government intervenes in the qui tam action, the relator receives between 15 and 25 percent of the amount recovered from the defendant. 43 On the other hand, if the government declines the case, then the relator receives 25 to 30 percent of the amount that the relator recovers from the defendant. In addition, relators are eligible to receive reasonable attorneys’ fees and expenses. 44 The relator may also be rewarded with 25 to 30 percent of the amount recovered by the government through other proceedings or actions taken in parallel to the relator’s suit. 45 ARTICLE 4 CIVIL MONETARY PENALTIES 4.1 Description of Statute . The Civil Monetary Penalties Law (CMPL) 46 empowers the Secretary of HHS to levy civil monetary penalties (“CMP”) against individuals and entities. 47 The Secretary of HHS has delegated much of that authority to the Office of Inspector General (OIG). 48 The following are actionable under the CMPL: (a) False or fraudulent claims and other similar misconduct; 49 (b) AKS and Stark law violations; 50 (c) Misconduct by contracting organizations; 51 (d) Emergency Medical Treatment and Labor Act (EMTALA) violations; 52 (e) Conveying the false impression that (x) an advertisement, solicitation, or other item was authorized, approved, or endorsed by HHS or CMS or (y) a person or organization has some connection with or authorization from HHS or CMS; 53
Adverse action reporting and disclosure violations; 54
(f) (g) (h) (i)
Select agent program violations; 55 Beneficiary inducement violations; 56
Improper sale of Medicare supplemental policies; 57
42 Id . 43 31 U.S.C. § 3730(d)(1). 44 31 U.S.C. § 3730(d)(2). 45 31 U.S.C. § 3730(c)(5). 46 42 U.S.C.S. § 1320a-7a. 47 42 U.S.C.S. § 1320a-7a(c). 49 42 C.F.R. § 1003.200. 50 42 C.F.R. § 1003.300. 51 42 C.F.R. § 1003.400. 52 42 C.F.R. § 1003.500. 53 42 C.F.R. § 1003.600. 54 42 C.F.R. § 1003.800. 55 42 C.F.R. § 1003.900. 56 42 C.F.R. § 1003.1000. 57 42 C.F.R. § 1003.1100.
48 “Civil Monetary Penalties and Affirmative Exclusions,” Office of Inspector General: U.S. Department of Health and Human Services , available at https://oig.hhs.gov/fraud/enforcement/cmp/background.asp (last accessed August 21, 2017).
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