Awareness : False Claims Act

False Claims Act

The False Claims Act makes it illegal to submit false or fraudulent claims for payment to Medicare or Medicaid. Claims may be false if the service:

  • is not actually rendered to the patient,
  • is provided but already covered under another claim,
  • is miscoded, or
  • is not supported by the medical record.

For False Claims Act violations, you can be fined up to three times the program’s loss,

  • plus $11,000 per claim.
  • Fines add up quickly because each claim can be a separate ground for liability.

You do not have to intend to defraud the Government to violate the False Claims Act.

  • You can be punished if you act with deliberate ignorance or reckless disregard of the truth.
  • This means you cannot hide your head in the sand and avoid liability.

For more information, please visit the Office of Inspecot General’s website at http://oig.hhs.gov/.