INFORMATION ABOUT
WHISTLE-BLOWER/QUI TAM CLAIMS

At least since the time of the Civil War, the Federal government has encouraged private citizens who are aware of a fraud being committed against the government to expose the fraud by bringing a lawsuit against the wrongdoer and sharing in the recovery. In the past, most of these cases have arisen in the defense industry. However, with the expansion of federal contracts in the health care field, more and more claims are being brought for fraudulent practices in this area.

We hope that the information presented here will help familiarize you with whistle-blower/qui tam claims. While the material below attempts to answer common questions in this area, State and local laws may significantly modify the facts set forth. Because all legal problems are unique, nothing provided here is a substitute for the advice of competent counsel. We strongly urge you to consult with an attorney licensed to practice in your state about any particular legal problem you may have.

ARE QUI TAM AND WHISTLE-BLOWER STATUTES THE SAME?

Yes. When translated, the phrase "Qui tam" means "he who brings an action for the king as well as for himself." It is pronounced "key tam." This is a type of lawsuit that allows persons or entities to sue a wrongdoer on behalf of the Federal Government.

MAY I PERSONALLY BRING A QUI TAM ACTION?

A qui tam action is one brought under the Federal False Claims Act by a private plaintiff (called a "relator") on behalf of the Federal Government. After the government investigates the claim, the Government may decide to join the relator's qui tam lawsuit. A private plaintiff may proceed, however, without any governmental participation.

WHAT ARE SOME TYPICAL QUI TAM LAWSUITS?

Many qui tam suits are brought by people working in the healthcare field who observe illegal practices by labs, insurance companies, physicians, hospitals, pharmaceutical companies and/or other medical service providers. Sometimes these are schemes to defraud the federal Medicare program, either by submitting false claims for services that were never rendered, or by overstating the service rendered. A qui tam action may also be brought where a health maintenance organization has deprived its subscribers of services that should be covered through the Medicare system.

WHAT SPECIFIC ACTIONS ARE PROHIBITED BY THE FALSE CLAIMS ACT?

The following actions are specifically prohibited by the False Claims Act. Doing any of these gives rise to a qui tam cause of action: (1) knowingly presenting, to an officer or employee of the United States Government, a false or fraudulent claim for payment; (2) knowingly making or using a false statement or claim to be paid by the Federal Government; (3) conspiring to defraud the Federal Government; (4) possessing or controlling property or money intended to be used by the Federal Government and willfully concealing it from the Federal Government; (5) delivering information to the Federal Government which is known to be untrue; (6) knowingly buying public property from an officer who is not authorized by the Federal Government to sell it; (7) knowingly making a false statement or record to avoid an obligation to pay or transmit money to the Federal Government.

A qui tam action does not include claims, records, or statements made under the Internal Revenue Code.

HOW DO I FILE A QUI TAM ACTION?

A qui tam action must be filed in a Federal District Court. A copy of the Complaint, along with a written disclosure statement of pertinent information in the relator's possession, must be served on the Attorney General and the local United States Attorney in the District Court where the lawsuit is initiated. The Complaint must be filed under seal, which means that all information must be kept confidential. The seal period will last for at least 60 days. During this period, the Federal Government investigates the allegations. After the government concludes its investigation, it then decides whether or not to join the relator's law suit.

WHAT HAPPENS IF THE GOVERNMENT INTERVENES IN MY LAWSUIT?

If the government decides to intervene in the matter, the Department of Justice has the primary responsibility for prosecuting your case. As the relator, you do however, have the right to continue as a party in the action. Your participation as the relator would then be subordinate to the Department of Justice. After the government decides whether to become involved in the matter, the seal period ends and the Defendant is served with the paperwork beginning the lawsuit.

WHAT HAPPENS IF I AM FIRED BY MY EMPLOYER FOR FILING A QUI TAM LAWSUIT?

Any employee who is discharged, demoted, suspended, threatened, or harassed by his or her employer for filing, investigating, or initiating a valid qui tam lawsuit is entitled to relief to make the employee whole. As the whistleblower, you are entitled to reinstatement of seniority status, double the amount of back pay owed you, including all interest owed, plus any special damages which may have occurred. You may also receive litigation costs and attorney fees.

DO I GET TO KEEP ANY OF THE MONEY THE GOVERNMENT GETS BACK?

In order to receive any monetary award for a qui tam claim, the relator must first file the lawsuit. Informing the Federal Government of wrongdoing is not enough to earn a reward. The amount of money awarded to you as the relator will vary from case to case. However, guidelines are set forth as to how much recovery a relator may receive. A relator may receive between 15 and 30 percent of the total recovery of a successful qui tam claim. If the government intervenes in the action, the relator generally receives 15 to 25 percent of the claim; but if the government does not proceed and the relator proceeds on his or her own and collects a judgment, the relator generally receives 25 to 30 percent of the recovery.

DO I NEED AN ATTORNEY TO INITIATE A QUI TAM ACTION?

Although an attorney is not mandatory, pursuing a qui tam lawsuit is a complex undertaking. If not handled properly, you may lose the case or lose your right of recovery. We strongly suggest you contact a lawyer before you start any formal proceedings.

If you have other questions or comments about this area or any other area in which we practice, please send us an E-mail message with your questions or comments and we will be happy to try to assist you.

LINKS TO OTHER INTERESTING INFO

The Qui Tam Information Center
False Claims Act Legal Center
Historical Overview of the Qui Tam Law
Information for Qui Tam Whistleblowers

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INFORMATION ABOUT WHISTLE-BLOWER/QUI TAM CLAIMS