Common theories
Some False Claims Act violations are straightforward: billing for services that were not provided, billing twice, or billing for a more expensive service than the one delivered. Others rest on certifications, express or implied, that the company complied with a rule that mattered to payment, such as program eligibility, quality standards, or cybersecurity requirements in defense contracts. Claims tainted by kickbacks are treated as false under federal health care law, and claims arising from prohibited physician referrals can be as well. The reverse false claim theory covers knowingly avoiding an obligation to pay the government, including keeping identified overpayments or underpaying customs duties. Federal enforcement priorities shift over time, and customs and tariff evasion and certifications made by recipients of federal funds have drawn particular attention.
Mistake versus violation
Not every billing error or regulatory breach is a False Claims Act violation. The law requires knowledge, which includes reckless disregard, so honest mistakes are generally not enough on their own. Materiality is also a real limit: the problem must be one that would affect the government's payment decision, not a minor or purely technical lapse. What often turns an error into a violation is what happened next, such as warnings that were ignored, audit findings left unresolved, or overpayments kept after they were identified. Documents showing how a concern was raised and handled therefore carry a great deal of weight.
If you suspect a problem
If you manage a business and suspect a violation, the first steps are to preserve the relevant records, stop the practice if it is ongoing, and get advice before anything is said outside the company. A company may weigh an internal review, a refund, or a self-disclosure to the agency involved, and each choice affects later exposure. If you are an employee who reported a concern internally and nothing changed, a different set of questions applies, including protection from retaliation. In a first meeting we sort out which position you are in and what the records show.
