I have recently heard of a civil action being filed by Social Security under the False Claims Act in an overpayment situation to try to treble the amount of the overpayment plus obtain a civil penalty. The false claims act allows Qui Tam actions, but this was not Qui Tam. This was being done without a criminal charge. I had not previously heard of the False Claims Act being used in a Social Security setting.
Is it new or unusual for Social Security to use the False Claims Act?
Is it new or unusual for Social Security to use the False Claims Act?
The False Claims Act stands alone and is not tied to Qui Tam actions. DHHS has used the False Claims Act in cases of huge Medicare overpayments known among the Social Security ALJ who used to hear them as big box cases. It is not criminal, however because of the threat of treble damanges for each claim - that is each filing in the Medicare arena, the government holds a huge club above the head of the provider. In addition the government recoups millions of dollars this way.
ReplyDeleteIn this context I assume that SSA will try to argue that each month's benefits accepted by a claimant will constitute an individual claim in order to elevate the amount of money it can threaten to recoup. I would argue that a claimant files one and only one claim.
It will be interesting to see how this plays out. Frankly, I imagine that the AUSA's in the civil division of the U.S. Attorneys' offices around the country will not be so anxious to push these claims. They have bigger fish to fry than the poor disabled Social Security Claimant and it is unlikely that they would ever recover any money from such a prosecution.
Well said, Judge Craig. nt
ReplyDeleteI would find this to be unusual. Most of these cases are handled by OIG, and OIG imposes civil monetary penalties of up to double the amount of the overpayment and $5,000 per false statement.
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