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

• A. Submitting a bill for a test or service never performed
• B. Submitting a bill for a performed service with proper documentation
• C. Providing care within standard practice
• D. Reporting accurate data to federal programs

Answer: (A)

Under the False Claims Act, fraud in healthcare often means seeking payment from a government program for services that didn’t happen. Submitting a bill for a test or service that was never performed is exactly that: you’re asking for payment for something that has no underlying service delivered. This is the prototypical false claim because the payment request rests on a non-existent service.

In contrast, billing for a service that was actually performed with proper documentation is legitimate, as is providing care that aligns with standard practice or reporting accurate data to federal programs. Those actions don’t involve claiming payment for something that didn’t occur, so they’re not examples of healthcare fraud under the Act.