Whistleblowers may be eligible to file a “Qui Tam” claim under the False Claims Act on behalf of the United States Government to recover federal dollars lost to these fraudulent practices.
The False Claims Act, 31 U.S.C. § 3729 et seq., provides for liability for triple damages and a penalty from $5,500 to $11,000 per claim for anyone who knowingly submits or causes the submission of a false or fraudulent claim to the United States.
Common False Claims Act violations include:
1. Submitting a false claim for payment: An example may be a physician who submits a bill to Medicare for medical services she knows she has not provided.
2. Making a false statement in support of a claim: An example of this may include a government contractor who submits records that he knows (or should know) is false and that indicate compliance with certain contractual or regulatory requirements.
3. Conspiring to get a false claim paid
4. Making a “reverse” false claim to avoid an obligation
An example of this so-called “reverse false claim” may include a hospital who obtains interim payments from Medicare throughout the year, and then knowingly files a false cost report at the end of the year in order to avoid making a refund to the Medicare program.
Over $20,000,000,000 Recovered
Since 1986, The False Claims Act has been used to recovery more than 20 billion dollars from businesses and individuals who committed fraud at the expense of the American Tax Payer. 12 billion dollars of that amount was recovered because of the actions of private citizens who used a provision of the False Claims Act to file “Qui Tam” suits on behalf of the United States Government.
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The Qui Tam Lawsuit
A private person, known as a “relator,” may bring a lawsuit on behalf of the United States, if the person has information that a company or individual has knowingly submitted or caused the submission of false or fraudulent claims to the United States. The relator need not have been personally harmed by the defendant’s conduct.
A successful qui tam relator may be entitled to receive:
- When the Government has intervened in the lawsuit: at least 15 percent but not more than 25 percent of the proceeds of the False Claims or Qui Tam action depending upon the extent of the contributions made by the relator to the successful pursuit of the Qui Tam lawsuit.
- When the Government does not intervene: between 25 and 30 percent of the money recovered in the Qui Tam lawsuit.
The False Claims Act has a very detailed process for the filing and pursuit of these claims. The qui tam complaint must, by law, be filed under seal, which means that all records relating to the case must be kept on a secret docket by the Clerk of the Court. Copies of the complaint are given only to the United States Department of Justice, including the local United States Attorney, and to the assigned judge of the District Court. The Court may, usually upon motion by the United States Attorney, make the complaint available to other persons.
The complaint, and all other filings in the case, remain under seal for a period of at least sixty days. At the conclusion of the sixty days, the Department of Justice must, if it wants the case to remain under seal, file a motion with the District judge showing “good cause” why the case should remain under seal. In the usual course, these motions request an extension of the seal for six months at a time.
At the conclusion of the investigation, or earlier if so directed by the Court, the Department of Justice must choose one of three options named in the False Claims Act:
1) intervene in one or more counts of the pending qui tam action. The government will then be the lead party in pursuing the claim against the defendant;
2) decline to intervene in one or all counts of the pending qui tam action. The Relator may then chose to pursue the claim without the government’s participation; or
3) move to dismiss the relator’s complaint, either because there is no case, or the case conflicts with significant statutory or policy interests of the United States.
As a matter of practice, The Department of Justice may also:
4) settle the pending qui tam action with the defendant prior to the intervention decision.
5) advise the relator that the Department of Justice intends to decline intervention. This usually, but not always, results in dismissal of the qui tam action.
Consult a Qui Tam Attorney
Our Dallas based lawyers will investigate qui tam/whistleblower claims under the Federal False Claims Act as well as other applicable state and federal laws in Texas and other states.
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