The False Claims Act was enacted by Congress in 1863 and allows whistleblowers to bring a qui tam lawsuit on behalf of the government against a company or an individual suspected to be defrauding the government. The Act typically allows whistleblowers to receive a percentage of any money recovered by the government as a result of the lawsuit and protects employees against retaliation.
Fraud as defined by the False Claims Act
Under the False Claims Act, companies, agencies, and government contractors commit fraud against the government by any of the following actions:
- Presenting a false or fraudulent claim for payment to the government
- Using a false record or statement to get a claim paid by the government
- Conspiring with others to get a false or fraudulent claim paid by the government
- Using a false record or statement to avoid or decrease an obligation to pay the government
Examples of conduct that courts have deemed fraudulent include:
Medical providers billing for services which were never provided; upcoding Medicare or Medicaid claims. Upcoding occurs, for example, when a provider misrepresents services performed as more expensive types of services than those actually performed or when a provider misrepresents patients’ diagnoses in order to increase the provider’s reimbursement.
Pharmaceutical companies marketing drugs for off-label use, or uses which have not been approved by the Food and Drug Administration; paying physicians kickbacks, or incentives, for promoting or prescribing certain drugs and medical devices.
Pharmaceutical companies or medical providers providing payments to medical providers in exchange for patient referrals, or for using certain medical drugs or suppliers.
Selling defective or substandard products to the government
Pharmaceutical and medical device companies failing to adhere to FDA good manufacturing standards; selling defective equipment to the government.
Government contractor fraud
Falsifying data on product pricing; failing to follow agreed-upon regulations; building contractors, medical contractors, or military contractors claiming their companies are minority owned when they are not. Minority-owned companies are those in which more than 51% of the assets are owned by members of ethnic monitory groups.
False Claims Act whistleblower rewards
Under the False Claims Act, whistleblowers are often eligible to receive a percentage of the government’s recovery. If the government pursues the case, the whistleblower is typically entitled to 15-25% of the government's recovery, and if the government declines to pursue the case, the whistleblower is entitled to 25-30% of the recovery.
The False Claims Act protects employees from retaliation
The False Claims Act protects employees from being harassed, demoted, terminated, or discriminated against by their employer as a result of exposing fraud. Under the False Claims Act, employees who suffer retaliation from their employers are legally entitled to relief, including getting their job back and receiving back-pay with interest and compensation for any retaliation-related damages.
Free consultations with False Claims Act attorneys
If you have information concerning a possible violation of the False Claims Act, speak with one of our whistleblower attorneys by calling toll-free at (866) 981-4800 or filling out the form to the right.