Growing Pains: Using the False Claims Act to Combat Health Care Fraud

Posted: 8 May 2000

See all articles by Pamela Bucy Pierson

Pamela Bucy Pierson

University of Alabama - School of Law

Abstract

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

Pierson, Pamela Bucy, Growing Pains: Using the False Claims Act to Combat Health Care Fraud. Alabama Law Review, Vol. 51, Pp. 57-103, 1999. Available at SSRN: https://ssrn.com/abstract=224615

Pamela Bucy Pierson (Contact Author)

University of Alabama - School of Law ( email )

P.O. Box 870382
Tuscaloosa, AL 35487
United States
(205) 348-1139 (Phone)
(205) 348-3917 (Fax)

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