Exploring the World of Qui Tam Cases: Understanding the Legal Protections for Whistleblowers

By David DeToffol | February 3, 2023

What is Qui Tam?

Qui Tam is a unique type of legal action where a person, including an employee, can report fraud committed by an individual or an organization against the Government. An attorney files the lawsuit on behalf of the whistleblower (referred to as the “relator”) and the Government. The case is usually filed “under seal,” meaning it is confidential, and the defendant is unaware of the lawsuit.

The Government investigates the allegations in Qui Tam Cases once a qui tam case is filed. Based on the outcome of the investigation, the Government decides whether to participate in the lawsuit actively. If the case is successful and the defendant compensates the Government, the relator is rewarded a percentage of the recovery as compensation from the Government. In addition, the False Claims Act statutes protect relators from retaliation for investigating and/or filing qui tam cases.

Qui Tam Cases Across Different Industries Qui tam cases can be brought to light in various industries, covering many forms of fraud. The most common qui tam cases today are in the health care industry (Medicare/Medicaid fraud), defense industries (fraudulent pricing/overbilling), financial services (mortgage guarantee fraud), medical and scientific grant research, for-profit colleges, government programs (such as the Small Business Administration), and environmental protection.

Examples of Qui Tam Cases

Medical office billing Medicare for tests not performed
Military defense contractors supplying faulty parts
Mortgage companies providing false information on borrowers’ credit scores
Company with a government contract to clean a toxic waste site, certifying work not done according to the contract
Hospitals improperly admitting inpatients from the emergency department
Durable medical equipment suppliers paying bribes to medical doctors or staff for product prescriptions
Healthcare system giving money, reduced rent, kickbacks, or other things of service to providers for patient referrals

Considerations When Filing a Qui Tam Case

Filing a qui tam case can be a complex process and comes with its own set of challenges. For example, a case may be dismissed if the information has already been brought to the Government’s attention, the information is already public knowledge, the case lacks sufficient details of the fraud, or the statute of limitations has run out. The focus has also shifted to whether the alleged misconduct impacts the reimbursement decisions of the affected government agencies, such as the Department of Health and Human Services or the Centers for Medicare and Medicaid Services.

Consult with a Qui Tam Whistleblower Attorney

If you are considering investigating or filing a qui tam case, it is crucial to consult with a seasoned qui tam whistleblower attorney as soon as possible. The number one mistake that most potential relators make is waiting too long. When they seek legal counsel, opportunities to gather evidence have been lost, the matter has become public, or the statute of limitations has expired. Don’t miss the chance to receive compensation as a relator by waiting too long.

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