The False Claims Act, despite its name, does not define what it means for a claim to be “false” or “fraudulent.” This post examines the primary ways courts have interpreted the False Claims Act’s falsity element and discusses common issues that arise concerning falsity.
Most False Claims Act cases involve allegations that the defendant knowingly presented or caused to be presented a “false” or “fraudulent” claim for payment, or made or caused to be made a “false” record or statement material to a false claim or to an obligation to pay money to the government. 31 U.S.C. § 3729(a)(1)(A)-(B), (G).
Thus, to establish liability under the False Claims Act, a plaintiff must prove, among other elements, the existence of a “false” or “fraudulent” claim or a “false” record or statement. But in contrast to other terms that are defined in the False Claims Act—like “knowingly” and “material”—the terms “false” and “fraudulent” lack statutory definitions. Therefore, these terms have been defined through judicial interpretation, resulting in several different theories of falsity and lines of argument for establishing falsity in False Claims Act cases.
In a False Claims Act case premised on factual falsity, the falsity involves a claim for payment that misrepresents the goods or services actually provided. For example, in False Claims Act cases against healthcare providers, common allegations of factual falsity include double-billing a...
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