What makes a claim false under the False Claims Act?

The False Claims Act (FCA) is intentionally broad.  The Supreme Court has described it as “intended to reach all types of fraud, without qualification, that might result in financial loss to the government.”  So, a claim is “false” if the government pays more or receives less than it would based on the truth. 

The FCA does not define the term false, but courts have identified different types of falsity that are potentially actionable.  First, claims can be “expressly” false if they misrepresent specific facts.  If a contractor claims to have sold bullet-proof vests to law enforcement, but the vests are not bullet-proof, the contractor has made an expressly false statement. 

Second, claims can be "impliedly" false if they misrepresent compliance with government rules and regulations.  If a healthcare provider bills Medicare and Medicaid for a service she is not qualified to provide, such as mental-health treatment, then the claim is impliedly false even if the service was provided. 

Third, claims can be false if they are based upon a false record, regardless of whether that record is provided together with the claim. 

Other types of false claims affect what the government receives, rather than what it pays.  Such “reverse false claims” conceal the amount of money or property a third party owes to the government.  For example, if a contractor knows that the government unintentionally overpaid for a service and misrepresents that fact to avoid repayment, those misrepresentations amount to a reverse false claim. 

Ultimately, courts apply a broad understanding of the term “false” to capture the full range of claims that can cause the government to lose money or property.   

To learn more about the False Claims Act and other whistleblower programs, go to www.mololamken.com and follow us on LinkedIn.  “Brilliant lawyers with courtroom savvy” — Benchmark Litigation.  Copyright MoloLamken LLP 2023.