Industries Commonly Involved in False Claims Act Cases

Almost anyone can sue under the federal False Claims Act as long as they bring information, which is either not publicly known or for which they are an original source. There are some exceptions.

It is not possible for military personnel to sue based on their military service and information obtained in the military. It is not possible to sue officials of the United States Congress, for example, under the False Claims Act. Aside from that, almost anyone can be a proper plaintiff-relator under the False Claims Act.

If you are interested in filing a claim regarding a particular agency, a distinguished false claims act lawyer can review the facts of your case and assist.

Industries Within False Claims

Two industries account for the vast majority of agencies involved in False Claims Act cases, the medical industry, and the defense industry. However, both medical services and defense contracting involve many different sub-industries.

Medical Industry

Medical cases are more successful under the False Claims Act than other types of cases. This is because the government is in a third party insurer position, and does not oversee day-to-day medical care, rather the government pays for medical care that individuals obtain.

Even though the government essentially pays for it, they are not in the position of knowing what is really happening in a hospital or what is really being done by a manufacturer to sell a medical device or to make a medical device, or even a pharmaceutical product.

As a result, payment for medical services can be made absent any real government understanding as to the circumstances regarding the provision of the product or service.

There are many areas of such fraud including:

  • Hospital care
  • Hospital providers
  • Laboratory tests
  • Durable medical equipment
  • Pharmaceuticals
  • Medical devices
  • Medical services
  • Ordinary patient care

Defense Industry

The other common area generating False Claims Act cases, defense contracting, is a huge business involving complicated contracts, sub-contractors, and often new technology. Unfortunately the businesses who handle defense contracts are not immune from committing fraud against the United States.

Joint Relators

Joint relators are common when filing a case against a company under the False Claims Act. More than one person may know about the same fraudulent activity at the same medical provider or the same government contractor, know each other and decide to file a case together. This is permitted under the federal False Claims Acts and the state False Claims Acts.

As long as their interests do not conflict two or more people, can be relators under the False Claims Act. The facts of cases filed may overlap but the evidence to support that case may be supported by two people bringing a case together.

Role of the Government

Government knowledge is not supposed to be an immediate defense to False Claims Act liability. In practice, it is much harder to maintain an action in a False Claims Act case, if the government knows what contractor is doing.

The third party beneficiary status of the government in medical claims usually means that cases regarding fraud against Medicare or Medicaid for example do not involve government knowledge of the falsity of such claims.