Which of the following is provided as an example of healthcare fraud under the False Claims Act?

• A. Submitting a bill for a test or service that was never done
• B. Providing care with informed consent
• C. Billing for services within normal practice
• D. Submitting accurate claims with proper documentation

Answer: (A)

Under the False Claims Act, healthcare fraud means knowingly presenting or causing to be presented a claim for payment that is false or not supported by the services actually provided. Submitting a bill for a test or service that was never performed is a classic example because it tries to obtain payment for something that did not occur and lacks any legitimate documentation to justify the charge. This reflects intent to defraud the payer, which the FCA targets.

Informed consent is a standard ethical and legal requirement for providing care and does not involve billing for services; it’s not fraud. Billing for services that are performed and within normal practice is legitimate when accurately described and documented. Submitting accurate claims with proper documentation is exactly what the FCA requires to avoid liability.