Growing Pains: Using the False Claims Act to Combat Health Care Fraud
Posted: 8 May 2000
The False Claims Act (FCA), 31 U.S. C. 3729, has had and will continue to have a tremendous impact on how the government deals with white collar criminals. This article discusses how the FCA works and how it offers important advantages, primarily flexibility in dealing with misconduct in complex regulatory areas where intent is difficult to determine and incentives are needed for those most knowledgeable about fraud to come forward. The FCA presents challenges however, as this article also discusses. Its hybrid criminal/civil nature and public/private plaintiff structure present unique nuances for litigants and courts. These nuances have caused splits in the courts on basic and important issues of FCA jurisprudence. While scatter-shot development of the law is to be expected when new legislation is enacted, the uncertainty surrounding the FCA is exorbitant, causing unfairness for parties and inefficiencies in the courts. Since the FCA's effectiveness as a law enforcement and consumer protection tool will not be realized until FCA case law has matured, its brightest days almost certainly lie ahead. For that reason, lawyers of tomorrow must have a working knowledge of the FCA. Given the federal government's active role as a purchaser and consumer in the health care arena, few health care providers will practice outside the FCA's reach.
JEL Classification: K32, K14
Suggested Citation: Suggested Citation