Google policy, FTC rule text and penalty figures checked October 23, 2026.
Fake Google reviews hit practices from two directions. Fake negatives arrive as spam, competitor attacks and extortion attempts. Fake positives are the ones a business buys or writes, and they now carry federal penalties. For the first kind: document the pattern, report each review under the right Google policy, and reply without confirming or denying anything about the reviewer. For the second, the answer is simple: don't.
Search demand tracks both problems. "Fake google reviews" gets 880 searches a month in the US and "report fake google review" 210. Meanwhile "buying google reviews" gets 5,400, which is why the FTC wrote a rule about it (Google Ads Keyword Planner data via DataForSEO, US, 12-month average to Sep 2026).
Signs a review is fake
Google's content policy (opens in a new tab) defines fake engagement as content "not based on a real experience," reviews "paid for, directly or in kind," and content "posted from multiple accounts by or at the request of one person." You can't see Google's data, but you can see patterns that point to those categories:
- Timing. Several reviews within hours or a day, after weeks of normal activity.
- Reviewer history. Accounts with no profile photo, no other reviews, or reviews only of businesses in other cities.
- Repeated wording. The same phrases, typos or structure across different reviewers.
- Details that don't fit. Complaints about a service you don't offer, a location you don't have, or staff who don't exist.
- A demand that follows. A message asking for money or favors to stop.
- Connections you can document. A reviewer who works for, owns or is related to someone at a competing practice, or a former employee.
Check your scheduling and billing records privately to see whether the name matches anyone. Keep the answer to yourself. Whatever you find, nothing in a public reply should reveal it.
Review bombing and spam attacks
A review bomb is a wave of negative reviews from people who weren't customers, often triggered by something outside the practice: a news story, a social media post, a dispute with one person who recruits others. Google's missing reviews page (opens in a new tab) notes that Google "might temporarily disable user-created content, including reviews, for certain Business Profiles or business categories to protect business owners."
Extortion is the commercial version. Google's extortion scam page (opens in a new tab) describes a sudden increase in one- and two-star reviews followed by a demand for money, goods or services to remove them. Its advice:
- Don't engage, and don't pay. Paying may encourage more attempts.
- Collect evidence right away: screenshots of each demand with dates, times and sender contact details, links to the reviews, and any usernames, emails or phone numbers.
- Submit Google's merchant extortion report form with that evidence.
Google says this channel is only for direct extortion demands. Ordinary spam goes through the normal reporting flow below.
How to report fake reviews to Google
Report each review individually. Per Google's reporting help page (opens in a new tab):
- Open your Business Profile and select Read reviews.
- Next to the review, select Report.
- Pick the reason that matches the policy. For fake reviews that's usually spam or fake content, or conflict of interest for a competitor or former employee.
- Select Send report.
Google says evaluation "typically takes several days." Track the status in the Reviews Management Tool. If a report comes back "Report reviewed - no policy violation," you can file a one-time appeal covering up to 10 reviews; add your evidence there.
For one account posting across many businesses, report the user, not just the review. In the Google Maps app, tap Business, then Reviews, tap the reviewer's name, then More and Report.
The full reporting and appeal walkthrough is in report and remove reviews.
Replying to a fake review without confirming anything
A public reply to a fake review is for future patients, not the reviewer. It should neither confirm nor deny that the person was a patient. That's the standard compliance approach, because "we've never seen you" is as revealing as "we saw you last Tuesday."
Illustrative example: reply to a suspected fake review (fictional Northgate Chiropractic) "We take all feedback seriously. Privacy rules prevent us from confirming or discussing whether anyone is a patient of our practice. If you'd like to talk about your concern, please call our office manager at (555) 010-0119."
Avoid accusing the reviewer of lying. Under the FTC's review rule, a "public false accusation" made with knowledge that it's false, or with reckless disregard for the truth, to get a review removed is prohibited (16 CFR 465.7 (opens in a new tab)). Even when you're sure, the policy-based report is the right channel.
Have your privacy officer approve this template along with the rest of your reply templates, and use it word for word.
Fake positive reviews: the FTC rule and Google's policy
The FTC's Trade Regulation Rule on the Use of Consumer Reviews and Testimonials (16 CFR Part 465) "went into effect on October 21, 2024," according to the FTC's Q&A (opens in a new tab). The FTC's announcement (opens in a new tab) named "AI-generated fake reviews" as one target. The parts that matter for a practice:
| Rule section | What it prohibits for a practice |
|---|---|
| 465.2 | Writing or creating reviews that misrepresent that the reviewer exists, had an experience, or what that experience was; buying reviews the practice knew or should have known were fake; getting staff or their relatives to post such reviews |
| 465.4 | Giving anything of value in exchange for, or conditioned on, reviews expressing a particular sentiment |
| 465.5 | Owners and managers reviewing their own practice without disclosing the relationship |
| 465.8 | Buying fake followers, likes or other social media indicators |
The FTC says the rule "authorizes courts to impose civil penalties for knowing violations." The statute behind that, 15 U.S.C. 45(m)(1)(A) (opens in a new tab), sets a penalty "for each violation," and 16 CFR 1.98 (opens in a new tab) puts the current inflation-adjusted cap at $53,088 per violation for penalties assessed after January 17, 2025. A batch of purchased reviews is a batch of violations.
Google's enforcement is faster and more visible. Its restrictions page (opens in a new tab) says that for fake engagement, Google may remove the reviews and also block new reviews for a set period, unpublish existing reviews for a set period, and display a warning telling consumers that fake reviews were removed. Google emails the owner before applying a restriction, and the business can appeal.
Incentives that aren't tied to a positive review are a gray area under the FTC rule but banned outright by Google; see the review incentive rules. The full legal walkthrough is in our explainer on the FTC fake reviews rule.
Documenting a pattern for escalation
When a single report fails, a documented pattern is what changes the outcome, whether in Google's appeal form or a conversation with an attorney. Keep a log you can copy into a spreadsheet:
| Field | Example entry (illustrative) |
|---|---|
| Date and time posted | Oct 3, 9:14 pm |
| Reviewer display name and profile link | "J. M." with link |
| Star rating and first line of text | 1 star, "Worst clinic in town" |
| Signals observed | Third one-star in two hours; no other reviews on account |
| Screenshot saved | Yes, file name |
| Date reported, reason chosen | Oct 4, spam |
| Status and date | Decision pending, Oct 4 |
| Appeal filed, outcome | Not yet |
Record your rating and review count weekly while an attack is under way. Medfy doesn't manage reviews, but its free marketing audit records your current rating and review count as part of the Google listing score, which gives you a dated baseline so sudden changes are easy to see.
When to bring in a lawyer: a reviewer makes specific, damaging false statements of fact, a competitor is clearly behind a campaign, or someone is threatening or extorting the practice. Defamation law varies by state, and suing a reviewer can draw more attention than the review itself. This is general information, not legal advice. Confirm how it applies to your practice with a qualified advisor.
For replies, removal and vendor choices beyond fake reviews, see our hub on online reviews and reputation.
Frequently asked questions
How can I tell if a Google review is fake?
Look for signals you can document rather than a hunch: a burst of reviews in a short window, reviewer accounts with no other activity, near-identical wording across reviews, details about services you don't offer, or a review followed by a demand for money. Check your own records privately, but never say publicly whether the person was a patient. Report what fits a Google policy category.
Will Google remove fake reviews left by a competitor?
It should, if Google can confirm it. Google's policy prohibits posting content on a competitor's place to undermine its reputation, and lists industry competitors as a conflict of interest. Report the review under the conflict-of-interest reason and, if it's declined, use the one-time appeal with evidence such as the reviewer's link to the competing business. Google makes the final call.
Is it illegal to buy Google reviews?
Buying fake reviews breaks the FTC's review rule, which took effect on October 21, 2024. It bars buying reviews a business knew or should have known were fake and paying for reviews that must be positive. Courts can impose civil penalties for knowing violations, capped at $53,088 per violation for penalties assessed after January 17, 2025. Google also removes them and can restrict the profile.
Should I reply to a review I believe is fake?
Usually yes, briefly, after you've reported it. Future patients read the reply, not your report. Use a neutral, approved template that neither confirms nor denies the reviewer was a patient and invites them to call the practice manager. Don't accuse the reviewer of lying in public; a knowingly false accusation aimed at removing a review is prohibited by the FTC rule.