What is the False Claims Act?
The False Claims Act (FCA) is a statute that allows individuals who observe other people or companies defrauding the government to be financially compensated for exposing fraudulent acts against the government. When a suit is brought under the FCA, it’s usually referred to as a qui tam case. The phrase “qui tam” was chosen refers to the ancient Latin phrase, “qui tam pro domino rege quam pro se ipso in hac parte sequitur.” This is a reference to the protections offered to whistleblowers who, according to a rough translation of this phrase, “bring an action for the king and for themselves.”
Obviously, our country does not have a king, but the phrase is appropriate when the brave whistleblowers who expose federal and state fraud help the government avoid misuse of taxpayer money. The person responsible for alerting the government to fraud is generally referred to in this kind of case as a relator.
What Kinds of Fraud Does it Cover?
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The most common types of qui tam lawsuit are those brought against individuals or medical practices accused of Medicare or Medicaid fraud and companies or individuals that commit defense contractor fraud, financial industry fraud, or grant fraud. However, there are many other examples of government fraud.
The FCA lays out several possible acts that could constitute fraud. These include knowingly presenting the government with a false claim, knowingly using a false record or statement in order to obtain a claim, conspiring with others to file a fraudulent claim, and knowingly using false records or statements to decrease or avoid monetary obligations to the government.
Health Care Fraud
Pharmaceutical and medical device companies may be charged with price fraud, off-label marketing, or marketing of defective devices. Hospitals and physicians may be charged with phantom billing, billing for unneeded procedures, up-coding, receiving kickbacks, and stark violations. Note that in cases where physicians are accused of receiving kickbacks, it is possible for the case to involve items of value such as gifts, trips, and meals in exchange for waiving co-pays rather than actual cash.
Financial Industry Fraud
Banks and other financial institutions can also be found in violation of the FCA. Common examples of financial fraud include financial industry fraud, mortgage fraud, loan fraud, securities pricing fraud, and emergency fund fraud. Basically, if a financial institution intentionally submits falsified information to secure funds from the government, the relator responsible for bringing the issue to the attention of the government may be eligible to receive whistleblower rewards.
Defense Contractor Fraud
Given how much money the federal government puts into defending our country, it’s essential that soldiers and civilian contractors keep an eye out for FCA violations. These may include overbilling for goods or services, the use of substandard materials, or failing to comply with contract specifications. The Truth-in-Negotiations (TINA) act also stipulates that the federal government be provided with access to all pricing data contractors have used to place bids for government projects, so those who are withholding relevant data may also be found liable for defense contractor fraud.
Grant Fraud
Research grants are offered by the government to support scientific inquiry into a broad range fields, from clinical medicine to highway safety. These grants must be used appropriately to fund relevant research and should never be siphoned into for-profit ventures or unrelated projects. Companies or individuals who inflate project-related costs or misrepresent their purposes in order to obtain grant funds can also be prosecuted under the FCA.
How Are These Cases Handled?
Our government’s Justice Department takes state and federal fraud seriously. Fraud takes taxpayer money away from important, sometimes life-saving projects. The severity with which the government views perpetrators of fraud helps to explain why whistleblowers need the protections offered by the False Claims Act.
These individuals take on personal and professional risks for the sake of the greater good. They risk losing their jobs due to exposing the companies they work for, but that risk pays off by reducing instances of fraud that could harm U.S. soldiers, medical patients, and others.
In order to minimize risk to whistleblowers, the lawsuit will be filed under seal, keeping it secret from everyone except for the government. This approach also gives the Justice Department the time it needs to investigate allegations without placing the whistleblower him or herself in jeopardy.
The majority of these types of cases are handled through a settlement, with those found liable required to pay up to three times the amount of money they caused the government to lose due to their acts of fraud in addition to penalties for each claim. In some circumstances, though, whistleblower cases go to trial.
Why Hire a Lawyer
If you’ve witnessed an instance of government fraud, the first thing you should do is to find a qui tam lawyer who can act as a legal advocate. This lawyer will help the government investigate allegations and in instances when the Justice Department chooses not to intervene, the whistleblower’s lawyer can help his or her client pursue a case independently.
Those who help the government recover funds through either a settlement or a trial can expect to receive between 15 and 20 percent of the money recuperated by the government. Relators who file a whistleblower lawsuit without government intervention will receive between 25 and 30 percent of the recovery.
Whistleblower investigations can take years to complete, especially when the Justice Department decides it is appropriate to intervene. It’s often necessary to partially lift the seal on the lawsuit in order to discuss a settlement with the person or company being accused. The relators in these cases deserve to feel confident that their rights will be protected when this occurs.
Those who hire a whistleblower attorney from Hadley Law Firm for help navigating the complex paperwork and interview process required to file qui tam cases have the benefit of knowing that they will be protected. The best place to start when filing a claim is to schedule a confidential consultation with an attorney who has experience representing whistleblowers.
If you’ve witnessed an individual or company defrauding the government, you can get in contact today with Hadley Law Firm to find out how we can help.
