Federal False Claims Act

PA False Claims Act Attorney image

Statute and Penalties

The False Claims Act (FCA) is a federal statute that applies to certain conduct. The statute provides that any person who knowingly submits a false healthcare claim to the government or causes another to submit a false healthcare claim to the government or knowingly makes a false record or statement to get a false claim paid by the government is liable. Anyone who violates the False Claims Act must pay a civil penalty ranging from $5,000 to $10,000 for each false claim plus up to three times the amount of damages which the Federal government sustains because of the act of the person (this is known as “treble damages”).


A key term is “knowingly”. The government must prove that a person must have submitted, or caused the submission of, the false claim with knowledge of the falsity. The terms “knowing” or “knowingly” means that a person, with respect to the information, has actual knowledge of the information, acts in deliberate ignorance of the truth or falsity of the information, or acts in reckless disregard of the truth or falsity of the information. The government need not prove specific intent to defraud. A “claim” is a request or demand for money or property made directly to the Federal government or to a contractor (Medicare contractor), grantee, or another recipient.

Prohibited Conduct

Individuals can also be prosecuted criminally under the False Claims Act statute when the conduct warrants it. In these cases, the Department of Justice will pursue penalties that include significant fines and jail time for violators. False Claims Act cases in the healthcare industry may include:

Civil Investigative Demand

Often, these matters start with a Civil Investigative Demand. Section 3733 of the statute authorizes the Attorney General to issue a Civil Investigative Demand requiring a person to produce documents, answer written interrogatories, and/or give oral testimony whenever the Attorney General has reason to believe that a person may be in possession, custody, or control of documentary material or information relevant to a false claim. 

Anyone served with a Civil Investigative Demand should retain counsel immediately. Healthcare attorneys who have experience with False Claims Act cases should carefully review the Civil Investigative Demand to ensure that it does not violate the statute. 

Specifically, a healthcare attorney should:

Qui Tam and Whistleblowers

Federal and state governments and insurance carriers routinely target healthcare providers who are suspected of fraudulent conduct, including the submission of false claims for payment. Often, these cases start with a qui tam action filed by a whistleblower. Whistleblowers can be a disgruntled current or previous employee or a patient. The U.S. government can also target suspected violators after having investigated other health care providers, manufacturers of medical equipment and supplies, or management consultants.

Submission of false healthcare claims for payment under the Medicare and Medicaid program is an extremely dangerous matter. Allegations of conduct prohibited under the False Claims Act requires representation by experienced healthcare attorneys. 

The Martin Law Firm healthcare attorneys are ready to help you respond to Civil Investigative Demands, allegations of False Claim violations and government interventions on qui tam claims.

Contact The Martin Law Firm today at (215) 646-3980 for a free case evaluation with an experienced healthcare attorney.

Please call (215) 646-3980 to schedule an appointment.

Practice Areas

Our legal team provides individualized legal solutions for our clients by offering high quality legal counsel and representation in diverse areas of law. Our attorneys regularly represent clients throughout Southeast Pennsylvania, including Montgomery County, Bucks County, Chester County, Delaware County, and Philadelphia County

Tell Us About Your Case

Please submit the form and an attorney will contact you shortly.
Please indicate how you would like to be contacted in the form.