Fraud against federally funded healthcare programs (such as Medicare or Medicaid) or the Paycheck Protection Programs (PPP) make up the bulk of suits, and recoveries, under the False Claims Act. A newly filed DOJ complaint[1] out of Idaho shows how the two can mix, and demonstrate some potential follow-on FCA effects from criminal healthcare fraud convictions or pleas can lead to follow-on FCA liability for PPP fraud.

On February 25, 2025, the Department of Justice sued a home health agency alleging it fraudulently obtained PPP and Economic Injury Disaster Loans (EIDL), two pandemic relief programs that helped businesses stay afloat during the COVID-19 pandemic. The alleged fraud stemmed from a certification in the loan applications that stated the “[a]pplicant is not engaged in any activity that is illegal under federal, state or local law.” But, according to the government, the healthcare provider was knowingly defrauding Idaho’s Medicaid program at the time, rendering the certification false. As a result, the government contends the defendant fraudulently obtained $3.5M in PPP and EIDL loans.

The government issued and subsequently forgave these loans in 2020. Two years later, in 2022, the owner of the company was charged with defrauding the state’s Medicaid program by submitting claims for services not provided or that were inflated. The company’s owner plead guilty and was sentenced to 180 days in jail and ordered to pay restitution of roughly $150,000.

Now—five years after the loans were issued and three years after the guilty plea—the government has sued to recover the forgiven pandemic relief funds. DOJ argues the Small Business Administration, which operates the PPP and EIDL programs, would not have approved or forgiven the loans if it knew that the applicant was illegally overbilling Idaho’s Medicaid program at the time.

The financial exposure in this civil FCA case far exceeds the amount at stake in the original criminal case (approximately $150,000). Now, the government seeks over $7 million in FCA damages, in addition to penalties.

This case should be a stark warning to those who allegedly (or admittedly) defraud the government and to potential whistleblowers who witness that conduct. With nearly 500 healthcare fraud convictions in a typical year, and at least 11.5 million PPP loans issued—not to mention other COVID relief programs—the situation faced by this home health provider is surely not unique. Whistleblowers who know of false certifications in PPP loan applications could potentially file an FCA case of their own, and, if successful, share in 15-30% of the government’s recovery.

The attorneys at Whistleblower Partners have extensive experience representing whistleblowers in cases involving healthcare and pandemic fraud. If you would like more information or wish to speak to an attorney at Whistleblower Partners, please contact us for a confidential consultation.

[1] United States v. Miller et al., 1:25-CV-00099 (D. Idaho).