The author provides a legislative history of the False Claims Act and discusses the potential impacts of the April 1993 amendments to the False Claims Act on the health care industry. The False Claims Act allows any private citizen with knowledge that a false claim had been submitted to the government for payment to bring a civil action in the name of the government to recover any damages suffered by the government. As an incentive, the person is entitled to a “bounty” plus costs. False claims in the health industry take three principal forms: nondelivery of services, delivery of unnecessary services, misrepresentation of services, charges, or costs. The author emphasizes that no specific intent to defraud is required. Items billed by a hospital in deliberate ignorance or reckless disregard for the truth or falsity of a bill are the only proof necessary.
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