Federal False Claims Act – 18 U.S.C. § 287
18 U.S.C. § 287 is a federal criminal statute that makes it illegal to submit false, fictitious, or fraudulent claims to the United States government.
This law is widely used by federal prosecutors in cases involving fraud against government agencies, including healthcare billing fraud, defense contracting fraud, and other financial schemes involving federal funds.
Unlike general fraud statutes, Section 287 specifically targets claims made for payment or approval by federal agencies.
It is designed to protect government resources and prevent individuals or businesses from obtaining money, property, or services through deception.
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Quick Answer: What Is 18 U.S.C. § 287?
18 U.S.C. § 287 makes it a crime to knowingly submit or cause to be submitted a false claim for payment or approval to the United States government or any of its agencies.
What Conduct Is Prohibited Under 18 U.S.C. § 287?
18 U.S.C. § 287 prohibits knowingly making or presenting a false, fictitious, or fraudulent claim to the United States government or any of its departments, agencies, or authorized representatives.
The statute criminalizes attempts to obtain money, property, or approval from the federal government through deception.
The law applies broadly to both individuals and organizations, including contractors, healthcare providers, and businesses that interact with federal programs.
Quick Answer: Prohibited Conduct Under Section 287
It is illegal to knowingly submit or cause to be submitted a false claim to the federal government in order to obtain payment, reimbursement, or approval.
Core Types of Prohibited Conduct
Federal prosecutors commonly rely on Section 287 to address several types of fraudulent activity.
Submitting False Claims for Payment
Any request for payment that contains false information or misrepresents entitlement to funds may violate the statute.
Examples include:
- Billing federal programs for services not provided
- Submitting invoices with inflated or fabricated charges
- Requesting reimbursement for ineligible expenses
Medical upcoding happens when healthcare providers submit exaggerated insurance billing codes to secure higher reimbursements. Federal prosecutors often accuse this practice of being health care fraud under 18 U.S.C. § 1347.
Causing a False Claim to Be Submitted
Liability extends beyond direct submission. A person can be charged if they cause another party to submit a false claim on their behalf.
Examples include:
- Directing employees to submit fraudulent billing
- Using intermediaries or third parties to process false claims
- Participating in schemes involving multiple actors
Using False Statements or Documentation
Providing false supporting materials to justify a claim may also violate the law.
Examples include:
- Falsified medical records or treatment notes
- Altered contracts or billing codes
- Misleading certifications or compliance documents
Concealing Material Facts
Omitting critical information that affects eligibility for payment may constitute fraudulent conduct.
Examples include:
- Failing to disclose overpayments
- Withholding information that would reduce or eliminate payment eligibility
- Misrepresenting compliance with program requirements
Industries Commonly Affected
While the statute applies broadly, enforcement is particularly common in:
- Healthcare billing and Medicare or Medicaid claims
- Government contracting and procurement
- Defense and infrastructure projects
- Federal grant and funding programs
What Conduct Is Not Typically Covered
Not every incorrect claim results in criminal liability.
Situations that may not qualify include:
- Good faith billing mistakes
- Contract disputes over payment terms
- Administrative errors without intent to deceive
The key distinction is whether the conduct involved knowing and intentional deception.
Example Scenario
A contractor submits an invoice to a federal agency for equipment that was never delivered. Even if the agency detects the issue before payment is made, submitting the false claim may still violate 18 U.S.C. § 287.
Why This Definition Matters
Understanding what conduct is prohibited under Section 287 is critical because the law focuses on intent and knowledge. Even a single false claim can lead to federal charges, and liability may arise from actions taken indirectly through others.
Careful compliance, accurate documentation, and prompt correction of errors are essential in avoiding exposure under this statute.
Federal Jurisdiction Requirements
To prosecute a case under Section 287, the government must prove that the claim was made:
- To the United States government
- To a federal department or agency
- To a government employee acting in an official capacity
Claims directed at private individuals or non-government entities generally do not fall under this statute.
Key Legal Elements
To secure a conviction, prosecutors must prove:
- A claim was presented to the federal government
- The claim was false, fictitious, or fraudulent
- The defendant knew the claim was false
- The defendant intended to obtain payment or approval
Intent is a critical element, and honest mistakes or billing disputes typically do not qualify as criminal conduct.
Examples of False Claims
Example 1: Healthcare Billing Fraud
A medical provider submits claims to a federal healthcare program for procedures that were never performed. This may violate 18 U.S.C. § 287.
Example 2: Government Contract Fraud
A contractor inflates invoices submitted to a federal agency to receive higher payments than authorized.
Example 3: False Reimbursement Request
An individual submits falsified documentation to obtain reimbursement from a federal program.
Common Industries Involved
False claims cases frequently arise in:
- Healthcare and medical billing
- Defense contracting
- Government procurement
- Grant funding and research programs
Healthcare fraud is among the most common areas in which Section 287 is enforced.
Related Federal Laws
Several federal statutes are often charged alongside or instead of 18 U.S.C. § 287.
31 U.S.C. §§ 3729–3733 – Civil False Claims Act
Creates civil liability for submitting false claims and allows whistleblowers to file lawsuits on behalf of the government.
42 U.S.C. § 1320a-7b – Anti-Kickback Statute
The Anti-Kickback Statute prohibits offering or receiving compensation for referrals involving federal healthcare programs.
18 U.S.C. § 1343 – Wire Fraud
Wire fraud applies to schemes that use electronic communications to defraud.
18 U.S.C. § 1341 – Mail Fraud
Mail fraud covers fraudulent schemes carried out through the mail.
18 U.S.C. § 371 – Conspiracy
Section 371 criminalizes agreements to commit fraud against the United States.
Penalties for Violating 18 U.S.C. § 287 (Federal False Claims)
| Penalty Type | Details | Range / Limit | When It Applies |
|---|---|---|---|
|
Federal Prison Sentence |
Incarceration for submitting false or fraudulent claims |
Up to 5 years per count |
Applies upon conviction for each false claim |
|
Criminal Fines |
Monetary penalties imposed by the court |
Up to $250,000 for individuals (higher for organizations) |
Based on severity and number of counts |
|
Restitution |
Repayment to the United States government |
Full amount of financial loss |
Mandatory in most cases involving financial harm |
|
Supervised Release |
Post-release monitoring and conditions |
Typically 1–3 years (or more depending on case) |
Follows completion of prison sentence |
|
Forfeiture |
Loss of assets connected to the offense |
Varies based on proceeds of fraud |
Applies when property or funds are tied to illegal conduct |
|
Federal Sentencing Guidelines Impact |
Sentence enhancements based on loss amount and conduct |
Increases guideline range significantly |
Applies in most federal fraud cases |
|
Multiple Counts Exposure |
Each false claim may be charged separately |
Penalties may stack across counts |
When multiple claims are submitted |
|
Professional Consequences |
Licensing or employment impacts |
Varies by profession |
Common in healthcare and government contracting cases |
Quick Summary: What Are the Penalties for 18 U.S.C. § 287?
A conviction for false claims can result in up to 5 years in federal prison per count, along with fines, restitution, and additional penalties depending on the amount of loss and number of claims.
Federal Sentencing Guidelines and Loss Amount
In false claims cases, federal sentencing is heavily influenced by the “loss amount,” which is the value of the claim submitted to the government.
Important considerations include:
- Intended loss may be used, even if payment was never made
- Larger loss amounts increase the guideline sentencing range
- Enhancements may apply for sophisticated schemes or multiple victims
However, the statutory maximum sentence remains five years per count under Section 287.
Common Legal Defenses
Defending against false claims charges requires a detailed analysis of intent, documentation, and compliance practices.
Lack of Intent
The government must prove that the defendant knowingly submitted a false claim. Good faith mistakes or misunderstandings may serve as a defense.
Mistake or Billing Error
Errors in coding, billing, or contract interpretation may not rise to the level of criminal conduct if there was no intent to defraud.
Insufficient Evidence
The prosecution must prove each element beyond a reasonable doubt. Weak or incomplete evidence may result in dismissal.
Reliance on Professionals
In some cases, defendants may rely on accountants, billing specialists, or legal advisors, which may negate intent.
Constitutional Violations
If evidence was obtained through unlawful searches or investigative misconduct, it may be suppressed.
Why Early Legal Representation Matters
Federal investigations often begin long before charges are filed. Early intervention by a defense attorney can:
- Prevent charges from being filed
- Negotiate favorable resolutions
- Limit exposure to criminal penalties
- Protect rights during investigations
Strategic defense is critical in complex federal fraud cases.
Frequently Asked Questions
What is considered a false claim under federal law?
Any request for payment submitted to the government that is knowingly false or misleading.
Can you be charged if the claim was never paid?
Yes. Intended loss can still be used to support criminal charges.
Is intent required for conviction?
Yes. The government must prove the defendant knowingly acted to defraud.
Are billing mistakes considered fraud?
Not necessarily. Good-faith errors are generally not criminal.
What is the maximum sentence under 18 U.S.C. § 287?
Up to 5 years in federal prison per count.
Can businesses be charged under this law?
Yes. Both individuals and organizations can be prosecuted.
Speak With a Federal False Claims Defense Attorney
If you are under investigation or facing charges under 18 U.S.C. § 287, it is important to act quickly. Federal fraud cases are complex and often involve extensive financial records and government resources.
An experienced federal criminal defense attorney can evaluate your case, challenge the evidence, and develop a strategy to protect your future.
Your optimal opportunity for a favorable result resides with an experienced California criminal defense attorney at Eisner Gorin LLP. To arrange a consultation, please contact us here.
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