A suit under the federal False Claims Act allows people who have insider information of fraud against the Government, known as a "federal whistleblower ", to file a suit to help stop the perpetrators from defrauding the Government. The False Claims Act seeks to deter fraud against the Government by providing for penalties of up to three times the amount of the fraud in addition to fines of $5,000 to $11,000 per violation. For example, It is estimated that the United States has collected almost $8 billion in fines and penalties in False Claims Act cases since 1986.
Generally, to prove a violation, the government must show that the defendant:
- Knowingly and wilfully (or with reckless disregard for truth or falsity)
- Made a false claim or statement (or used a false document)
- That was material (i.e., sufficiently important or relevant to influence decision making)
- Regarding a matter within the jurisdiction of a government agency
- With knowledge of its falsity
An act is done knowingly and wilfully if it is done voluntarily and intentionally, and not by mistake or another innocent reason. Thus, an individual can be found guilty for making a false statement only if the individual knew the statement was false at the time it was made.
Also, the following are general rules with regard to laws criminalising false claims and statements to government agencies:
- An individual can be found guilty for making a false claim or statement even if the claim or statement is not made directly to a governmental department or agency. That is, a false claim or statement can be made to a third party as long as it involves a matter within the jurisdiction of a governmental department or agency.
- An individual can be found guilty for making a false claim or statement even if the government was not deceived by the falsity.
- An individual can be found guilty for making a false claim or statement even if the government did not rely on the falsity.
- An individual can be found guilty for making a false claim or statement even if the government did not suffer a loss in reliance on the falsity.
- For an individual to be found guilty of making a false claim or statement, the claim or statement at issue must have been capable of influencing the government entity involved.
Often, countries have various related laws that criminalise false or fraudulent statements to government agencies. Common types of false claims and statement laws of greatest importance to fraud examiners include:
- Laws that prohibit the making of fraudulent demands for money against the government
- Laws that prohibit false statements or reports on credit applications or related document submitted to a bank or credit institution
- Laws that prohibit schemes to obtain money or property from governments by means of false or fraudulent pretences involving government contracts.
There are many types of fraud perpetrated against the federal governments, including, but not limited to, contractor fraud, defense industry fraud, healthcare fraud, environmental fraud, grant fraud, defense industry fraud, government sales fraud, welfare fraud, healthcare fraud, Medicare fraud, Medicaid fraud, off-label prescription use fraud, tax fraud (in excess of $2 million), and procurement fraud.