Types of Qui Tam Cases
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 include:
Healthcare
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
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
Whistleblower litigation refers to legal actions initiated by individuals, often current or former employees, who bring forward allegations of wrongdoing or illegal activities within an organization. These individuals, known as whistleblowers, typically uncover instances of fraud, corruption, safety violations, or other forms of misconduct within their workplace.
IRS Tax Fraud
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
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
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
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
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
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”).
Qui Tam Litigation: Safeguarding Public Funds and Upholding Integrity
In the intricate landscape of qui tam litigation, the United States has witnessed a significant escalation in the enforcement of the False Claims Act, targeting government fraud and safeguarding federal funds. This complex legal framework empowers qui tam relators, often whistleblowers, to file a qui tam lawsuit on behalf of the federal government, thereby challenging deceitful entities that submit false claims to extract unwarranted payments. A quintessential qui tam case unfolds when a private citizen, or qui tam plaintiff, observes misconduct, such as the misuse of government funds or fraudulent government contracts, and decides to take a stand. The role of the qui tam lawyer is pivotal, navigating through the dense terrain of qui tam law, ensuring that the qui tam complaint is meticulously crafted to meet stringent legal standards.
The narrative of qui tam actions is further enriched by the vigilant oversight of the Justice Department and the Attorney General, who meticulously assess each qui tam claim, determining the government’s stance on intervention. Qui tam litigation not only recuperates ill-gotten gains but also serves as a robust deterrent against future misconduct. The False Claims Act lawsuit, a cornerstone of consumer protection, acts as a bulwark against exploitation, extending its protective umbrella over a myriad of sectors, including government contracts, healthcare, and environmental regulation. As qui tam actions and whistleblower claims continue to surge, the dedication and expertise of qui tam lawyers play a crucial role in shaping a legal environment where integrity and accountability are paramount, safeguarding the sanctity of public resources against the backdrop of government fraud.
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
Notice
This website is designed to provide general information only. This information is not and should not be construed to be legal advice. The transmission of the information found on this website also does not result in the formation of a lawyer-client relationship.
You should be aware that qui tam claims are subject to a Statute of Limitations. The area of limitations periods is complex. There are also first to file rules, public disclosure bars, original source issues, and varying limitations in pursuing retaliation claims. If you wish to pursue your claims, you should promptly seek the opinion of an attorney regarding the merits of your qui tam claim and the applicable statute of limitations.