What is a qui tam whistleblower lawsuit?

False Claims Act whistleblowers (also known as relators) are eligible to receive 10% to 30% of the recovery.  In an intervened case, the relator can obtain 15% to 25% of the recovery, depending upon the extent to which the person substantially contributed to the prosecution of the action.

In a non-intervened case, the relator can obtain between 25% to 30% of the recovery.  Additionally, a qui tam relator (whistleblower) who prevails in an FCA action—regardless of whether the government intervenes—is entitled to “reasonable expenses which the court finds to have been necessarily incurred, plus reasonable attorneys’ fees and costs.” 31 U.S.C. § 3730(d).  Qui tam whistleblower lawsuits have enabled the government to recover more than $60 billion.

The False Claims Act also protects whistleblowers from retaliation.

False Claims Act Qui Tam Whistleblower Lawyers

If you are seeking representation in a False Claims Act qui tam action, call our whistleblower lawyers today at 202-262-8959.  We also represent whistleblowers in False Claims Act retaliation and NDAA retaliation actions.

2022 Qui Tam False Claims Act Settlements

Examples of the type of fraud that can qualify for a qui tam whistleblower award or bounty include:

• Violating the federal Anti-Kickback Statute and the FCA by billing millions of dollars for unlawfully forcing patients to endure 72-hour hospital stays for observation and mental illness treatment against their will.  Pacific Health Corp. paid $16.5 million to settle claims that it doled out kickbacks for referrals of homeless patients and provided them with unnecessary treatments.
• Making improper payments to doctors to get them to write prescriptions for two Teva products. In 2020, Teva agreed to pay $54M to settle a qui tam case alleging that it paid doctors speaker fees and pricey to prescribe multiple sclerosis drug Copaxone and Parkinson’s disease drug Azilect.
• Paying doctors and kickbacks or financial incentives to get patient referrals.  In 2020, Agnesian HealthCare paid $10M to settle a qui tam case alleging that its compensation plan for doctors violated the Stark Law, the Anti-Kickback Statute, the federal False Claims Act and the Wisconsin False Claims by rewarding and offering incentives to its network of affiliated doctors to refer Medicare and Medicaid patients exclusively to Agnesian doctors and facilities.
• Upcoding in the form of billing for 14,000-level tissue transfers, which should have been billed as lower-level wound repairs.
• Making misrepresentations regarding certified cost or pricing data in violation of federal procurement laws and regulations.  See 10 U.S.C. 2306a; 41 U.S.C. Chapter 35; FAR 15.403-4 and 15.403-5.
• Submitting to Medicare claims for medically unnecessary treatment. United States ex rel. Riley v. St. Luke’s Episcopal Hosp., 355 F.3d 370, 376 (5th Cir. 2004).  Medicare will only pay for inpatient hospital services if “a physician certifies that such services are required to be given on an inpatient basis for such individual’s medical treatment, or that inpatient diagnostic study is medically required and such services are necessary for such purpose.” 42 U.S.C. § 1395f(a)(3).
• Billing federal healthcare programs for unnecessary medical testing.  In April 2022, Physician Partners of America LLC agreed to pay $24.5 million to resolve allegations that they violated the FCA by billing federal healthcare programs for unnecessary medical testing and services, paying unlawful remuneration to its physician employees and making a false statement in connection with a loan obtained through the Paycheck Protection Program.  DOJ alleged that PPOA caused the submission of claims for medically unnecessary urine drug testing by requiring its physician employees to order multiple tests at the same time without determining whether any testing was reasonable and necessary, or even reviewing the results of initial testing to determine whether additional testing was warranted.

False Claims Act Qui Tam Whistleblower Lawyers’ Answers to Frequently Asked Questions

A qui tam whistleblower can be eligible for a large recovery.  But there are many pitfalls and obstacles to proving liability, and there are unique rules and procedures that govern qui tam whistleblower cases.  Therefore, it is critical to retain an experienced False Claims Act whistleblower lawyer to maximize your recovery.  This FAQ provides an overview of some of the key aspects of False Claims Act claims.

• What types of false claims are prohibited by the False Claims Act?
• What is the first-to-file bar in False Claims Act qui tam cases?
• What is the requirement to file a False Claims Act qui tam action under seal?
• Are False Claims Act whistleblowers protected against retaliation?
• What is a reverse false claim?
• What is the statute of limitations for a False Claims Act qui tam action?
• What is the public disclosure bar in the False Claims Act?
• What is the original source exception to the public disclosure bar?
• What is materiality under the False Claims Act?
• What is “Scienter” Under the False Claims Act?
• Is a Violation of the Anti-Kickback Law Also a Violation of the False Claims Act?
• Does the False Claims Act Prohibit Bid-Rigging?
• Does the False Claims Act Prohibit Fraudulent Inducement of a Contract?
• Can a violation of Good Manufacturing Practices give rise to False Claims Act Liability?
• Is there a heightened pleading requirement for False Claims Act qui tam cases?
• Does the False Claims Act authorize treble damages?
• Must a False Claims Act qui tam relator have firsthand knowledge of all aspects of the fraud?

5 Limitations on Eligibility for a Qui Tam Whistleblower Award

False Claims Act Qui Tam Whistleblower Protections

Courageous whistleblowers that come forward to report fraud deserve robust protection against retaliation.  Below is a list of common questions about key aspects of the anti-retaliation provisions of the False Claims Act and the Defense Contractor Whistleblower Protection Act.

• How does the NDAA whistleblower retaliation law protect whistleblowers at federal contractors and grantees?
• Must an NDAA Whistleblower Retaliation Plaintiff Prove a Subjective Belief of a Violation?
• What whistleblowing is protected under the False Claims Act anti-retaliation provision?
• Does the False Claims Act protect whistleblowers against retaliation?
• Is whistleblowing in the course of performing job duties protected under the False Claims Act?
• Is False Claims Act Whistleblower Protection Limited to Disclosures About the Whistleblower’s Employer?
• Does the participation of a supervisor with knowledge of protected whistleblowing in the decision to take an adverse personnel action prove knowledge under the False Claims Act whistleblower protection provision?
• Can a False Claims Act whistleblower retaliation plaintiff obtain double back pay (two times lost wages and benefits)?
• Are employees whose jobs require investigating fraud against the government required to meet a higher pleading standard?
• Are “duty speech” disclosures protected under the False Claims Act?
• What protections are available to federal contractor whistleblowers under the NDAA whistleblower protection law?
• Can False Claims Act whistleblowers use confidential documents to report fraud to the government?
• What is the purpose of the False Claims Act whistleblower protection provision?
• Does the False Claims Act protect a whistleblower who refuses to violate the Act?

Impact of Government Decision Not to Intervene in a Qui Tam Action

If the DOJ does not intervene in a qui tam action, the qui tam relator (whistleblower) can prosecute the claim on behalf of the government.  As DOJ argued in a Statement of Interest in United States ex rel. Fischer v. Cmty. Health Network, Inc., No. 1:14-cv-1215, “[t]he Government’s decision to decline certain allegations, however, does not give rise to any inferences related to the materiality or the merits of those allegations. Moreover, allowing a qui tam defendant to draw an inference that materiality cannot be established because the United States declined to intervene would significantly and negatively impact the statutory scheme established by Congress, which permits and encourages qui tam relators to proceed with FCA allegations even when the Government has declined to intervene upon those allegations. The Seventh Circuit has expressly stated that “[t]here is no reason to presume that a decision by the Justice Department not to assume control of the suit is a commentary on its merits.” U.S. ex rel. Chandler v. Cook County, Illinois, 277 F.3d 969, 974 n.5 (7th Cir. 2002). This presumption is not valid because “[t]he Justice Department may have myriad reasons for permitting the private suit to go forward including limited prosecutorial resources and confidence in the relator’s attorney.” Id.; see also U.S. ex rel. Atkins v. McInteer, 470 F.3d 1350, 1360 n.17 (11th Cir. 2006) (noting that the United States “may have a host of reasons” for declining to intervene that have nothing to do with the merits of a particular allegation). As the Supreme Court has recognized, there are real costs and burdens attendant to intervening in an FCA action. U.S. ex rel. Eisenstein v. City of New York, New York, 556 U.S. 928, 933-34 (2009). The United States may decline to intervene on meritorious claims when it has reason to believe that its resources would be better expended elsewhere, or that the burdens of litigating those claims are not justified by the potential recovery. “[T]he simple fact that the government did not intervene has no probative value and is not relevant.” U.S. ex rel. El-Amin v. George Washington Univ., 533 F. Supp. 2d 12, 22 (D.D.C. 2008). “[A]ssuming the government looked unfavorably upon each qui tam action in which it did not intervene,” as CHN contends, is not the law, and would be “antithetical to [the text and] the purpose of the qui tam provision[,]” which authorizes relators to litigate claims on behalf of the United States after declination. Id. at 21. Indeed, “the plain language of the [FCA] clearly anticipates that even after the Attorney General has ‘diligently’ investigated a violation [of the FCA], the Government will not necessarily pursue all meritorious claims; otherwise there is little purpose to the qui tam provision permitting private attorneys general.” U.S. ex rel. Berge v. Bd. of Trustees of Univ. of Ala., 104 F.3d 1453, 1458 (4th Cir. 1997); see also 31 U.S.C. § 3730(a) (“[i]f the Attorney General finds that a person has violated” the FCA, “the Attorney General may bring a civil action…” (emphasis added)); U.S. ex rel. Williams v. Bell Helicopter Textron, Inc., 417 F.3d 450, 455 (5th Cir. 2005) (finding that the FCA “does not require the government to proceed if its investigation yields a meritorious claim”). Thus, the mere fact that the Government declined to intervene as to some allegations in this case cannot support the conclusion that materiality is lacking as to those allegations.”

Qui Tam Whistleblowers/Relators Have Standing to Recover Assets to Satisfy a False Claims Act Judgment

Qui Tam Resources