False Claims Act Overview (31 USC 3729)
The principal civil fraud statute for healthcare: prohibits knowingly presenting false claims to the federal government, with treble damages, per-claim penalties, qui tam relator actions, and integration with AKS and Stark.
Primary source
31 USC 3729 — Office of the Law Revision Counsel →https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title31-section3729&num=0&edition=prelim
Verified May 23, 2026 · This is the authoritative regulator URL. The summary below is a research aid; the linked source controls.
Additional sources
31 USC 3729 — the False Claims Act (FCA) — imposes civil liability on any person who knowingly presents (or causes to be presented) a false or fraudulent claim for payment to the federal government.
Penalties: treble damages (three times the government's loss) plus civil penalties per false claim. The per-claim penalty is adjusted annually for inflation; the DOJ inflation-adjustment table tracks the current minimum and maximum.
Key features:
- Reverse false claims: liability for knowingly retaining an overpayment.
- Conspiracy: liability for conspiring to commit FCA violations.
- Qui tam: private relators (whistleblowers) may file suit on behalf of the government and share in recoveries (15-30%).
- AKS link: a claim resulting from an AKS violation is per se a false claim under the ACA's amendment to 42 USC 1320a-7b(g).
- Stark link: claims for DHS provided pursuant to a prohibited Stark referral are false claims.
Healthcare is the largest single FCA enforcement area. Annual DOJ recoveries from healthcare FCA cases routinely exceed $2 billion. Self-disclosure to OIG SDP, Stark SRDP, or to DOJ via voluntary disclosure can substantially reduce multipliers and penalties.
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Related across the archive
- RegulationFCA 'Knowingly' Standard and Reckless Disregard (31 USC 3729(b))'Knowingly' under the FCA includes actual knowledge, deliberate ignorance, and reckless disregard of the truth or falsity of the information; no specific intent required.
- RegulationFCA Qui Tam Provisions (31 USC 3730(b))Private whistleblowers (relators) may file civil FCA actions on behalf of the government under seal; DOJ investigates and may intervene; relators share in recoveries.
- RegulationAnti-Kickback Statute Overview (42 USC 1320a-7b(b))Criminal prohibition on knowingly and willfully soliciting, receiving, offering, or paying remuneration to induce or reward federal health care program business, with safe harbors at 42 CFR 1001.952.
- GlossaryFalse Claims ActFederal statute (31 USC 3729-3733) that imposes liability on persons and companies who defraud federal programs.
- ComplianceCommunicable Disease Reporting: CDC NNDSS + State Health Department RequirementsFederal 42 USC § 247b + CDC NNDSS + state reportable-disease lists: who reports, what conditions, timelines (immediate to weekly), and 45 CFR § 164.512(b) HIPAA permissibility.
- SRAHIPAA Settlements and Civil Money Penalties: A Small-Practice Reading ListHow HHS Office for Civil Rights publishes its enforcement record, the tiered civil money penalty structure at 45 CFR 160.404, and what recent small-practice settlements actually say.
- Glossary60-Day Overpayment RuleACA requirement that Medicare and Medicaid overpayments be reported and returned within 60 days of identification.
- GlossaryWhistleblower (Qui Tam)Under the False Claims Act, a private person who files suit on behalf of the United States alleging fraud and shares in the recovery.
Last reviewed May 23, 2026 · Citation verified May 23, 2026
Research aid, not legal advice. This summary is an administrative research aid prepared by D3rx. It does not certify compliance, provide legal advice, replace counsel, or guarantee an audit outcome. For authoritative regulatory text follow the primary source link at the top of this page. The practice remains responsible for reviewing, adopting, and maintaining its compliance program.