Stronger Together: Harnessing the Power of State and Federal False Claims Acts in Sealed Investigations  

Sponsor-Provided Content
Ashley Kenny, Esq. (Pietragallo Gordon Alfano Bosick & Raspanti, LLP)

State False Claims Acts (“FCAs”) are an underutilized mechanism by relators. All but six states have their own FCA or Qui Tam provisions. Not only are relators potentially leaving money on the table by not including relevant state claims, but they’re also not using the investigative capabilities state attorneys general (“AGs”) possesses to their advantage. Harnessing the powers of both state and federal FCAs provides relators the best chance of success. 

Dual filing under state and federal FCAs harnesses the investigative and enforcement resources of multiple agencies while the case remains under seal. It expands the evidentiary record through diverse document streams and aligns the interests of federal and state authorities in uncovering and remedying fraud that touches both federal and state treasuries. 

A primary advantage with dual filing is the capacity of state AGs and state Medicaid Fraud Control Units to conduct independent, parallel investigations to those conducted by the federal government while the complaint is under seal. This dynamic often yields a more diverse and detailed factual record which is critical in the early stages of FCA investigations. State agencies also possess unique subject-matter expertise pertaining to state-administered programs, most notably Medicaid, and can access state-specific data repositories, provider enrollment files, claims adjudication systems, and prior administrative actions. Importantly, access to these state-specific resources also provides relators with a clearer picture of potential damages.  

Often times, the seal period is exponentially more productive in a dual-filed case. While the government evaluates the allegations, state agencies can issue targeted requests, engage program-integrity analysts, interview more localized state-level witnesses, and coordinate with state regulators. Because fraudulent schemes may manifest differently across jurisdictions, through distinct billing edits, managed care arrangements, or waiver programs, state-led investigations frequently reveal patterns that corroborate or refine the federal theory of liability. Understanding the mechanics of the alleged fraud across various states also enables relators to demonstrate that the fraud is systemic rather than episodic—an especially important part in federal charging and settlement analyses. 

Dual filing also multiplies the sources and types of documents available to the governments and relators. Federal and state agencies can request and obtain different categories of records specific to their statutes and data repositories. For example, state inquiries may yield Medicaid managed care encounter data, provider cost reports submitted only to state agencies, communications with state program officials, and documents related to state licensure or compliance audits. When combined with federal datasets, such as Medicare claims, TRICARE records, or federal grant materials, these state-derived records can bolster the materiality, scienter, and causation showings in a federal FCA theory. 

The involvement of both state and federal agencies may also provide relators with a stronger remedial posture. The presence of a robust and engaged government team can enhance negotiation leverage and promote comprehensive resolutions that address both federal and state allegations.  

In short, filing under both state and federal FCAs transforms the seal period into a coordinated, multi-pronged investigation, enriches the evidentiary record with state-specific documents and analyses, and aligns enforcement interests across governments. For relators, this approach can materially strengthen federal allegations and position the case for efficient and effective resolution. 

This post was written and provided by Pietragallo Gordon Alfano Bosick & Raspanti LLP, a sponsor of the 2026 Qui Tam Conference.