Colorado Healthcare Fraud/Medicare Fraud Enforcement
In Colorado, major healthcare fraud is civilly and criminally prosecuted by the District of Colorado United States Attorney’s Office.
The federal government sometimes accomplishes this task with the assistance of the Colorado Medicaid Fraud Control Unit (MFCU). Both entities are, in turn, often assisted in their efforts by the bravery and actions of whistleblowers.
Modeled after the federal False Claims Act, the Colorado False Claims Act (Colorado Medicaid False Claims Act) permits private citizens to bring qui tam actions on behalf of the State of Colorado to recover treble damages and civil penalties. Colo. Rev. Stat. §§ 25.5-4-303.5 et seq.
Nolan Auerbach & White represents whistleblowers in federal court only. We will bring cases on behalf of whistleblowers under the Colorado qui tam statute as part of an action under the federal False Claims Act. We do so under the Court’s pendent jurisdiction.
The liability provisions of the Colorado Medicaid False Claims Act, Colo. Rev. Stat § 25.5-4-305(1), provide that it is unlawful to:
(a) Knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval;
(b) Knowingly makes, uses or causes to be made or used, a false record or statement material to a false or fraudulent claim;
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(g) Conspires to commit a violation of paragraphs (a) to (f) of this subsection (1)…
Cases completed in Colorado that were originally brought in a Colorado federal court include:
Dr. William Choi and three companies he owned paid the United States $2.35 million to resolve civil allegations that Dr. Choi received illegal kickbacks from distributors of spinal implant devices that he used in surgeries he performed. Dr. Choi allegedly created two distributorships: Nexus Spine, LLC and 4D Spine, LLC, which provided spinal implant equipment, such as rods, screws and cages, to hospitals for use in surgeries that Dr. Choi performed. The whistleblower in this case was an employee of Dr. Choi’s medical practice and one of the distributorships. The case was resolved in February 2020 and handled by the U.S. Attorney’s Office for the District of Colorado.
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James Conrad, Former Director of Program Integrity at CMS, and Former FBI Health Care Fraud Analy