Posted By Steve Alder on Jul 31, 2024

The False Claims Act in healthcare is a law that can be used by government agencies to take enforcement action against contractors who knowingly submit false claims, cause another to submit false claims, or knowingly make a false record or statement to get a false claim paid by a federal healthcare program. False Claims Act healthcare complaints can also be filed against contractors who fail to return Medicare and Medicaid overpayments.

The False Claims Act was enacted in 1863 “to prevent and punish frauds upon the Government of the United States”. The Act was introduced with the intention of stopping dishonest contractors selling faulty supplies and equipment to Union troops during the Civil War. Significantly, the Act included a “qui tam” provision which permits private citizens to sue dishonest contractors on behalf of the government and retain a percentage of the proceeds.

Despite the availability of the Act, successive Attorneys General mostly ignored it – preferring instead to pursue criminal prosecutions against dishonest contractors rather than civil prosecutions. This led to an industry in which “enterprising” private citizens would wait for an Attorney General to file a criminal indictment against a government contractor, and would then file a civil qui tam False Claims Act lawsuit against the same contractor.

The practice continued until 1943 when Attorney General Francis Biddle raised concerns to Congress that the number...

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