Number: RS22982
Title: The False Claims Act, the Allison Engine Decision, and Possible Effects on Health Care Fraud Enforcement
Authors: Jennifer Staman, American Law Division 
Abstract: The False Claims Act (FCA), an important tool for combating fraud against the U.S. government, generally provides that a person who knowingly submits, or causes to be submitted, a false or fraudulent claim for payment to the U.S. government may be subject to civil penalties and damages. Recently, the Supreme Court examined the scope of the FCA in Allison Engine v. United States ex rel. Sanders, in which a former employee of a subcontractor brought an action against other subcontractors who had allegedly submitted a false claim to the prime contractor on a U.S. defense contract. The Court struck down the FCA claim against the subcontractors, holding that a demonstration that a false claim was paid for with government funds, without more, does not establish liability under 31 U.S.C. §§ 3729(a)(2) and (a)(3). Under these sections, the Court found that a plaintiff must prove that the defendant intended to defraud the government (and not just a recipient of government funds) when it submitted or agreed to make use of false claim. Given that the FCA is frequently invoked in the health care context, it has been questioned how this decision could affect these cases. This report provides an overview of the FCA and the Allison Engine decision, analyzes how this decision could affect certain FCA health care claims, and discusses the proposed False Claims Correction Acts (S. 2041 and H.R. 4854), which, if enacted, could limit the application of the Allison Engine decision.
Pages: 6
Date: Updated November 6, 2008