What is a Qui Tam Lawsuit?

Blowing the whistle on fraud in the workplace can be a challenging decision, especially when considering the potential for retaliation and financial repercussions. However, the significant impact of the individuals who come forward and file qui tam lawsuits cannot be overstated.  That is why Miller Shah LLP is committed to helping clients navigate the complex statutory schemes designed to protect whistleblowers and ensure accountability and integrity. 

What Is a Qui Tam Lawsuit?

“Qui Tam” is derived from the Latin phrase “qui tam pro domino rege quam pro se ipso in hac parte sequitur,” meaning “Who sues on behalf of the King as well as for himself.”  Essentially, statutes containing qui tam provisions allow private individuals, known as relators or whistleblowers, to file lawsuits on behalf of the government against entities committing fraud. One of the most common statutory sources for qui tam lawsuits is the False Claims Act (FCA).

The FCA is a longstanding tool against fraud stemming from Civil War-era misconduct.  It became an even more powerful tool upon its enhancement in 1986, enabling the government to collect significant monetary recoveries from individuals or entities who submit false claims for payment or reimbursement from federal programs.

Whistleblowers who bring suit under the FCA’s qui tam provisions can receive between 15% and 30% of the total recovery the U.S. government achieves from the defendant. This financial incentive serves a crucial purpose in encouraging individuals to report fraudulent activities. To date, False Claims Act recoveries exceed $75 billion, with approximately $7.8 billion awarded to whistleblowers.

Situations That May Warrant a Qui Tam Lawsuit

Various scenarios may serve as the origin for a qui tam lawsuit.  Common instances include:

Overbilling and Illegal Billing Schemes

Entities may charge for more work than performed, inflate costs, or submit invoices for services not rendered. When such bills are ultimately submitted to the government for payment, they may violate the FCA.

Kickbacks

Offering or accepting bribes to influence contract outcomes or secure favorable treatment during project execution constitutes a violation of the FCA. Kickbacks undermine professional judgment and compromise the fairness and integrity of governmental payment processes.

Healthcare Fraud

Healthcare fraud takes many forms, common examples of which include billing Medicare and Medicaid for unnecessary medical services, upcoding procedures, or engaging in illegal marketing practices. Healthcare fraud not only unnecessarily drains public funds but also compromises patient care.

Defense Contract Fraud

Misusing funds allocated for specific projects, inflating costs, or engaging in billing irregularities are common forms of defense contract fraud. Such activities violate the FCA in addition to jeopardizing national security and wasting taxpayer money.

What Is the Process of Filing a Qui Tam Lawsuit?

Filing a qui tam lawsuit involves several steps and requires meticulous attention to detail.  A breakdown of some of the most important actions is below:

• Gathering Evidence: The whistleblower must save anything that could serve as potential evidence of fraud. This includes documents, emails, and any other relevant information substantiating the whistleblower’s claim.
• Contact an Attorney: Engaging an attorney experienced in qui tam litigation can make all the difference in bringing a successful whistleblower lawsuit.  The legal team at Miller Shah LLP leverages its decades of experience and extensive knowledge of qui tam lawsuits and the FCA to guide whistleblowers through each step of the process, ensuring their rights are protected and their goals are achieved.
• Filing the Complaint: The complaint is filed under seal in federal court, meaning it remains confidential while the government investigates the allegations. This period can extend for multiple years, depending on the complexity and scope of the case.
• Government Intervention: Based on the investigation, the government will decide whether to intervene. If they choose to do so, the relevant branch of the Department of Justice takes over responsibility for prosecuting the case, though the whistleblower may stay involved. If the government decides not to intervene, the whistleblower may proceed with the case with their attorneys’ assistance.
• Litigation and Resolution: Qui tam litigation is often a protracted process involving contentions discovery and motion practice. Cases may result in settlements, trials, or dismissals. Successful claims result in recoveries for the government, and the whistleblower may receive a portion of the recovered funds.

Take Action With a Qui Tam Attorney

Qui tam lawsuits are instrumental in combating government fraud and an experienced attorney team is essential to protecting whistleblower rights and achieving results. At Miller Shah LLP, we offer dedicated legal counsel to individuals taking the brave step of exposing fraudulent activities. If you believe you have witnessed fraud and want to understand your rights under the False Claims Act, contact us today to discuss your case.