False Claims Act

The False Claims Act is an important law passed by Congress to allow the U.S. taxpayers to recover billions of dollars from fraud on the U.S. by government contractors every year. It is a unique law in that it allows citizens with evidence of fraud against the government to sue on behalf of the government in order to recover the stolen funds. These individual whistleblowers, called ?Relators? are awarded a portion of the funds recovered, typically 15-25%. The False Claims Act covers fraud involving any federally funded contract or program (states also have laws covering fraud on states) in which a contractor falsifies test results or other information regarding the quality or cost of the products it sells. For example, submitting bills for services not rendered would be covered by this law. It also covers health care providers that bill Medicare or Medicaid for services not performed or which were not necessary or where a grant recipient charges the government for costs not related to the grant. Here are a few more examples; 1) performing inappropriate or unnecessary medical procedures in order to increase Medicare reimbursement; 2) Billing for work or tests not performed; 3) automatically running a lab test even thought he test was not specifically requested; 4) double billing-charging more than once for the same goods or services; 5) upcoding-inflating bills by using diagnosis billing codes that suggest more expensive illness or treatment; 6) winning a contract through kickbacks or bribes; 6) billing for unlicensed or unapproved drugs