Types of Qui Tam Cases

TYPES OF QUI TAM CASES PURSUED UNDER THE FALSE CLAIMS ACT

Since the revitalization of the False Claims Act (”FCA”) by the 1986 Amendments, the government has aggressively pursued civil, criminal, and administrative actions against those who swindle money from the federal treasury through kickbacks, fraudulent claims, or off-label marketing, just to name a few. Since there is no shortage of corrupt contractors, the U.S. government, Qui Tam lawyers and relators, the private citizens who bring action on behalf of the government, have been aggressively pursuing Qui Tam claims. The Department of Justice reported, in fiscal year 2014, that False Claims Act FCA recoveries were the highest in years, totaling nearly $6 billion. Since its inception during the Civil War and its signing into law by President Abraham Lincoln on March 2nd, 1863, FCA has been integral in recovering for the U.S. taxpayer and the Federal government from unscrupulous individuals and entities. The Department of Justice believes the False Claims Act has been the single most successful anti-fraud act ever signed into law.

Although the majority of these recoveries from a Qui Tam lawsuit were in the area of healthcare fraud, significant recoveries were also made in other areas. Most often, qui tam cases involve healthcare (Medicaid, Medicare) and defense contractors, but some also relate to financial services, environmental regulation, oil, gas and mining, and scientific research. Some common types of whistleblower cases and types of fraud are listed here: Clink the links to learn more and watch the video.

Healthcare Qui Tam Cases-Fraud and abuse accounts for almost ten percent of total government Medicaid and Medicare spending on healthcare, or approximately $120 billion per year. A whistleblower lawsuit may involve overbilling through the deceptive practice of upcoding. The potential harm caused by fraud in the Medicaid/Medicare healthcare industry cannot be overstated.

Defense Contractor / Military / Government Procurement Qui Tam Cases-Since its enactment, actions against defense contractors have dwindled, and healthcare fraud has become the leading source for qui tam actions. However, fraud in the defense arena is still a concern for the government. In light of recent wars overseas, defense contractors surely will fall under the government’s microscope.

Whistleblower Litigation

IRS Tax Fraud Cases– In December 2006, Congress passed the Extension of Tax Relief Act of 2006 These amendments authorize the IRS to create a Whistleblower Office to process tips received from individuals who “spot tax problems in their workplace, while conducting day-to-day personal business, or anywhere else they may be encountered.

Environmental Regulation Qui Tam Cases-Environmental regulation is a major challenge for the government. The cases in this area usually involve the liability of government contractors who fail to comply with or report misconduct in connection with environmental regulations.

Prevailing Wage Act Qui Tam Cases-The purpose of prevailing wage laws is to prevent contractors and subcontractors from landing profitable government projects, by bidding lower than their competitors at the expense of their employees.

Education Fraud Qui Tam Cases-False Claims Act (FCA) liability arises in the area of educational fraud where educational institutions violate the Higher Education Act of 1965 (“HEA”)1 or knowingly make false promises to become eligible to receive government funds.

Oil Gas and Mining Qui Tam Cases-The False Claims Act imposes liability on a defendant in connection with underpaying royalty payments to the Government that typically involve amounts owed for use of minerals, oil, and gas on public lands.

Scientific Research Qui Tam Cases-The cases in this area involve the liability of hospitals and universities for false information in obtaining federal funding for research. These cases generally involve the reimbursement of research expenditures by hospitals conducting federally funded medical research, or universities with research grants from the National Institute of Health (“NIH”).

For more information and case citations, please see “Federal False Claims Act and Qui Tam Litigation,” published by Law Journal Press (2010).

For more information, email quitam@bafirm.com

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