Not every healthcare fraud matter is a criminal case. For many Orange County providers, the first serious threat is civil: a False Claims Act letter alleging tripled damages and per-claim penalties for “knowingly” submitting false claims to Medicare, Medi-Cal, or other government programs. My Rights Law Criminal Defense and DUI Lawyers defends Santa Ana providers, practices, and companies facing False Claims Act investigations, qui tam actions, and the criminal referrals that often follow them.
The FCA — 31 U.S.C. section 3729 — imposes civil liability on anyone who knowingly presents a false or fraudulent claim for payment to the United States, knowingly makes a false record material to a false claim, or knowingly avoids an obligation to pay the government. “Knowingly” includes deliberate ignorance and reckless disregard — a lower bar than criminal intent. Damages are trebled, and penalties attach per claim. Because claims are counted individually, a practice with thousands of billed claims faces staggering theoretical exposure even where actual overpayment was modest.
Most FCA cases begin as qui tam actions under 31 U.S.C. section 3730(b) — sealed complaints filed by former employees, business partners, or competitors, who can receive 15–30% of the recovery. The case sits under seal while DOJ investigates; the defendant often learns of it only when subpoenas arrive or the seal lifts. California has its own False Claims Act for state-program claims, and the California Insurance Code has parallel false-claim provisions for private insurance. One audit can spawn all three.
Many FCA matters resolve through negotiated settlements without admissions of liability, and early, well-documented cooperation materially improves terms. But FCA conduct can also be referred for criminal prosecution under 18 U.S.C. section 1347 — civil and criminal strategy must be coordinated from day one.
Get help now for your Santa Ana False Claims Act case.
Yes. DOJ reviews qui tam cases for criminal potential, and the same evidence that supports civil liability can support 18 U.S.C. section 1347 charges. That is why FCA defense includes criminal-risk assessment from the start.
Treat it as seriously as a grand jury subpoena. CID responses are sworn statements in a fraud investigation — never answer one without counsel reviewing every document and word.
Relators are paid from the recovery. Retaliation against them creates separate liability. Where the relator fabricated or leaked, those facts matter in negotiation — but speak through counsel, not directly.
This page is legal information, not legal advice, and reading it does not create an attorney-client relationship. Laws and enforcement priorities change, and outcomes depend on the facts of each case.
Santa Ana office: My Rights Law Criminal Defense and DUI Lawyers - Santa Ana, 611 W Civic Center Dr #400, Santa Ana, CA 92701. Call 888-702-8882 for a free confidential consultation.
This page was written by the My Rights Law Editorial Team and reviewed for legal accuracy by Bobby Shamuilian.
Attorney Shamuilian is the founder and managing partner of My Rights Law and is widely recognized as a legal authority, frequently appearing as a legal analyst and TV pundit on national news outlets.
He has earned a perfect “10.0 – Top Attorney” rating on AVVO and a “10.0” rating on Justia, and has been named among the “Top 40 Under 40” and the “Top 100 Trial Lawyers” by The National Trial Lawyers.
With his proven expertise and dedication, Mr. Shamuilian is committed to protecting your rights and achieving the best possible outcome for your case.
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