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An introduction to the False Claims Act

Because there is no federal law prohibiting nursing home abuse and neglect, government attorneys have utilized a financial fraud statute to address nursing home abuse and neglect. The False Claims Act prohibits the knowing submission, or causing the submission, of false claims to the government. Each false claim submitted is subject to treble damages and a penalty of between $5500 and $11,000.

The falsification of records also subjects health care providers, including nursing homes, to potential criminal liability. The government has criminally prosecuted providers for falsifying charts to cover up medication errors or negligence.

The theory behind using the False Claims Act imposes liability based on a false certification of compliance with the law governing nursing home care or hospital care. When a claim is submitted, the health care provider provides an “express certification” that they have complied with proper standards of care. However, when a provider submits a claim for care that is alleged to have been substandard or neglectful, the government asserts that the provider submitted a false claim. The “express certification” implies compliance with all regulations.

To read the Act.