Although this blog focuses mainly on the federal False Claims Act (FCA), other antifraud statutes feature in the qui tam relator and government enforcement toolkit. Key among them: the California Insurance Frauds Prevention Act (IFPA).
The IFPA is a state antifraud statute that, while modeled on the FCA, stands on its own because it targets fraud on commercial insurance. The IFPA has become a primary vehicle in California for addressing alleged healthcare fraud. Over the last decade, qui tam IFPA actions have resulted in tens of millions of dollars in settlements in healthcare fraud matters. Going forward, qui tam relators and the State of California will continue to use the IFPA to pursue significant recoveries for alleged healthcare fraud. This is a statute every provider doing business in California needs to know about. The main features of the IFPA are discussed below.
When it was enacted in 1993, the IFPA focused only on workers’ compensation fraud. Recognizing the need to combat other types of insurance fraud, California expanded the statute’s reach over time. Codified at Cal. Ins. Code § 1871, et seq., the IFPA has evolved to cover many types of insurance fraud, including health insurance fraud.
In fact, the IFPA recites a legislative finding that “health insurance fraud is a particular problem for health insurance policyholders” and “account[s] for billions of dollars annually in added health care costs nationally.”
As it relates to...
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