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What are the penalties for a False Claims Act violation?

The False Claims Act (FCA) is a federal law that allows the government to hold those financially accountable who it believes have knowingly submitted false claims for payment to the government. A common example is a health care provider filing a false or fraudulent claim for payment to Medicare or Medicaid.

How serious is the government about FCA cases?

The federal government takes these cases very seriously and will aggressively pursue an investigation of any potentially viable allegations of a violation. The Department of Justice (DOJ) reports that in the fiscal year of 2020 alone it collected over $2.2 billion in settlements and judgements connected to FCA cases.

How much can an FCA violation cost?

The DOJ explains that a violation can result in a penalty of $10,000 for each false claim as well as double the government’s damages. The feds also note that this law is continually updated and could increase in the future. A recent update includes an increase in how much the government can go after. The feds can now hold those who violate the FCA accountable for treble, or triple, damages plus an additional penalty linked to inflation.

Are there defenses to allegations of an FCA violation?

The defenses available will depend on the details of the situation. One example can include a review of the claim in question. Ideally, the health care provider will have records available to support the claim and establish it was not a false or fraudulent thus defeating the FCA allegations.

This is just one potential defense strategy to these allegations. It is wise for those who face allegations of an FCA violation or find themselves under federal investigation to seek legal counsel to discuss their options. It is also important to note that the penalties extend beyond the immediate financial expense. Additional penalties can include the inability to bill government agencies like Medicare and Medicaid in the future. Physicians or nurses who face allegations could also face ramifications from the nursing or medical board that could have a negative impact on their professional license. These are just some of the reasons that it is important to take these allegations seriously.

Attorney John Rivas is responsible for this communication