Fraud Types

Virtually any fraud on the government can provide the basis for a Qui Tam action and reward. Individuals who report fraud receive a reward pursuant to the Qui Tam provisions of the federal False Claims Act, which prohibits almost all frauds on the government. Generally, any false representation, or act designed to conceal important information, that results in a financial loss to the government is covered by the False Claims Act.

• Knowingly presenting (or causing someone else to present) a false or fraudulent claim to the government for payment. (The claim itself doesn't have to be false, if it is part of a larger fraud.)
• Knowingly creating or using a false record or statement to get a fraudulent claim paid or approved by the government.
• Conspiring with someone else to get a fraudulent claim paid.
• Making a false statement or record to conceal or reduce an obligation to pay money to the government.

These provisions in the False Claims Act, and others, cover virtually every form of fraud against the government. When a medical lab submits a bill to Medicare for a test it didn't actually perform or the treating physician didn't order, the lab violates the False Claims Act. When a hospital overstates its costs to receive a higher allowance under Medicare, it violates the Act. When a government contractor, operating under a cost plus contract, conceals that the costs he actually incurred are lower than those in the budget he submitted to the government, he violates the Act.
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