False Claims Act

< Whistleblower Law

False Claims Act Attorneys

Common False Claims

Engaging in activities that involve making material misrepresentations to obtain money from the government can result in liability for false claims under the law.

To pursue such cases, it is crucial to consult an experienced False Claims Act attorney who can provide guidance. Some examples of common false claims include:

  • Overbilling: Charging the government more than the actual cost of goods or services.
  • Double billing: Submitting multiple claims for the same goods or services.
  • Upcoding: Assigning higher billing codes to services or goods than what is warranted.
  • Billing for services not provided: Charging for goods or services that were never delivered.
  • Providing worthless material or services: Supplying goods or services that are of no value or quality.

These categories represent a few of the broad types of false claims that can be subject to legal action under the law.

Understanding the False Claims Act

The federal False Claims Act holds individuals liable for attempting to defraud the government, including submitting false claims. It also imposes liability for:

  • Creating false statements to obtain a claim payment.
  • Conspiring to submit false claims or use false statements to obtain a claim payment.
  • Making reverse false claims, where a company withholds property or money owed to the government.
  • Under the Act, successful cases may result in treble damages, meaning the defendant could be ordered to pay three times the amount of damages caused to the government.

Recent Amendments

Over the years, significant changes have been made to how false claims cases are handled. The government now has the authority to waive restrictions on filing cases under the False Claims Act when there has been a public disclosure. Additionally, the success of the False Claims Act has led to the establishment of additional whistleblower reward laws, such as the SEC Whistleblower Program. State False Claims Acts have also been modeled after the federal law, resulting in a comprehensive legal framework.

Filing Restrictions and Public Records

Certain restrictions apply to successful filing and maintenance of false claims actions. If the government has already pursued a case based on the same facts in civil court, no action can be initiated. Additionally, if the government is already pursuing monetary penalties, no action will be maintained.

The public disclosure bar has been amended to allow individuals to file cases even if there has been public disclosure, and the government can waive this restriction. Whistleblowers can file cases as an original source of information if they possess independent knowledge and provide information to the government before filing a case in court.

Types of Fraud

False claims cover various areas, including selling drugs for off-label uses, marketing medical services through kickbacks, or making misrepresentations about equipment and services provided by defense contractors. Each area can give rise to a false claims case. Healthcare fraud cases can involve medically unnecessary procedures or charging for services not rendered. In the defense industry, cases may involve contractors providing substandard goods or services.

Fraud Laws

Understanding common false claims necessitates familiarity with fraud laws and government activities. Medicare, for example, involves significant government spending, and fraudulent practices can lead to False Claims Act violations. Laws such as the Stark Anti-Self-Referral Law and the Anti-Kickback Statute make kickbacks in the medical field illegal and can result in automatic False Claims Act liability.

Defense Fraud

Defense contractor fraud represents another significant area of False Claims Act cases. The False Claims Act originated during the Civil War to combat fraud against the Union Army. Defense contractor fraud persists to this day.

Civil Fines and Rewarding Whistleblowers

Civil fines can be imposed on defendants, with the amount increasing over time due to legislation requiring inflation-adjusted fines for each violation of the False Claims Act.

The False Claims Act also provides rewards to whistleblowers, known as plaintiff-relators. These rewards, ranging from 15% to 30% of the government’s collection, encourage individuals to report fraud. State False Claims Acts may offer even higher reward provisions than the federal law.