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How Does a Qui Tam Lawsuit Work?

How Does a Qui Tam Lawsuit Work

How Does a Qui Tam Lawsuit WorkQui tam lawsuits work by rewarding a whistleblower who sues a person or organization that is defrauding the US government. Since the government is unaware of most of the fraud taking place against it, it relies on whistleblowers to bring the fraud to the government’s attention. One way this occurs is when the whistleblower sues the wrongdoer on the government’s behalf. In return for doing this, the whistleblower gets a portion of the money recovered by the US government.

How Does a Qui Tam Lawsuit Work:  Background

Qui tam lawsuits fall under the False Claims Act. The False Claims Act is an old law, dating all the back to the Civil War. Back then, various contractors were defrauding the Union (and Confederate) government by selling war goods that were faulty, inadequate or otherwise unfit for use. To counter this problem, Congress passed the False Claims Act, which created liability on those who would defraud the government.

As a way of making the False Claims Act more effective, Congress added a qui tam provision. This allows individuals to collect a reward if they help the US government recover money taken through fraud. This “bounty” sounds like a good idea, but how exactly does the process work?

How Does a Qui Tam Lawsuit Work:  The Beginning

To start a qui tam lawsuit, there must be a whistleblower (also called a relator). A relator is someone who has knowledge of the fraud and can use that knowledge to sue (or help the US government sue) the person or organization who is defrauding the government. The government relies on relators because the government is unaware of most of the fraud that takes place. Additionally, even if the government suspects possible fraud, it won’t have anywhere near the knowledge or access to information that someone inside the defrauding organization would have.

Once someone decides to be a whistleblower, they must file a complaint in federal court, just as they would in a normal civil lawsuit. But what makes the qui tam lawsuit different is that the relator must file the complaint “under seal.” This means the whistleblower cannot reveal the qui tam lawsuit to the defendants or the general public. Instead of notifying the defendant, the relator will notify the relevant US Attorney and Attorney General of the United States by providing them with a copy of the complaint.

The next step involves the government investigating the alleged fraud. This can take many months. While this investigation takes place, the qui tam complaint will remain under seal. The US government will complete its investigation and conclude whether to “intervene” or join the lawsuit. Even if the government decides not to intervene, the relator can still continue the lawsuit. However, it makes the chances of success much less likely. This is for a couple of primary reasons:

First, the relator can’t rely on the resources of the United States to pursue the qui tam lawsuit. If the defendant is a powerful and wealthy corporation, it might be able to force the relator into giving up on the case, regardless of how much merit it has.

Second, if the US government decides not to join the case, it probably means it believes there’s not a good chance of winning. The defendant knows this, so if it sees the government backing out, it knows the relator doesn’t have a strong case.

Whether the US government joins or not, the case can continue with the relator setting out to prove that fraud has taken place.

How Does a Quit Tam Lawsuit Work:  Potential Reward for the Whistleblower

Assuming the qui tam lawsuit is successful, the relator may recover a certain percentage of the total amount of money recovered by the government. The percentage will vary depending on the facts of the case, whether the government intervened and if so, how much assistance the relator provided during the case. Typically, the relator can expect a reward of between 10% and 30% of the total recovery. The higher 25% to 30% amount is usually for relators who win cases the US government refused to join.

How Does a Qui Tam Lawsuit Work:  Whistleblowing Risks

The idea of collecting a sizeable reward entices many people to become whistleblowers. But to see a case all the way through to completion takes a lot of time, hard work and risk. For example, when the relator files the qui tam lawsuit, they have some level of anonymity, but many organizations can eventually figure out who the whistleblower might be if they go digging. Even if the anonymity remains at the beginning of the case, the person’s name usually comes out during the trial. And in the rare cases where it does not, the anonymity vanishes when the person collects their reward.

All this means the relator is at risk of retribution and retaliation. The False Claims Act has special provisions to prevent this, but it’s difficult to prove retaliation. Much of it is very subtle and underhanded. A whistleblower can possibly become blackballed after filing a qui tam lawsuit, resulting in the inability to find work in their chosen industry or field – but it can be impossible to prove who did it.

Interested in Getting an Award under the False Claims Act?

If you’d like to learn more about how does a qui tam lawsuit work, please contact Bothwell Law Group by calling 770.643.1606 today.

Is There a Deadline for Filing a Whistleblower Qui Tam Lawsuit?

deadline for filing a Whistleblower Qui Tam Lawsuit

deadline for filing a Whistleblower Qui Tam LawsuitThe deadline for filing a whistleblower qui tam lawsuit is generally six years following the alleged fraud against the US government. This time constraint is also called a statute of limitations. The statute of limitations exists in most civil causes of action.

Deadline for Filing a Whistleblower Qui Tam Lawsuit

Anyone who chooses to file a qui tam lawsuit must file the qui tam complaint either:

● Six years after the alleged fraud took place, or
● Three years after an official of the US government knew (or should have known) of the alleged fraud, but no more than ten years after the alleged fraud took place.

Most of the time, the deadline for filing a Whistleblower Qui Tam lawsuit will be six years. So if the defendant submitted a false invoice to the US government on June 3, 2011, the person bringing the qui tam lawsuit (also known as the relator) must file the qui tam complaint no later than June 3, 2017.

But in some instances, a relator may be able to file its qui tam lawsuit for a possible fraud that goes back ten years, but only if the qui tam lawsuit filing is within three years of when the relator knew (or should have known) about the alleged fraud. Confused? Don’t worry; it gets worse.

Not all courts interpret the “ten year” qui tam statute of limitations as applying to relators. Most courts will only apply this extended deadline to the US government when it joins in the lawsuit. So, to summarize:

● A relator will always have at least six years from the date of the alleged fraud to bring a qui tam lawsuit.

● In a minority number of federal courts, the relator will have ten years from the date of the alleged fraud to start the qui tam lawsuit, as long as the relator is filing the qui tam lawsuit within three years of when he or she learned of the alleged fraud.

● In a majority number of federal courts, the ten-year deadline never applies to relators, just the six-year deadline. So only the US government can take advantage of the extended deadline if it joins in a qui tam lawsuit within three years of learning of the alleged fraud.

The Wartime Suspension of Limitations Act

Until recently, the law was unclear as to whether the Wartime Suspension of Limitations Act could extend the False Claims Act’s qui tam statute of limitations. The Wartime Suspension of Limitations Act temporarily pauses the statute of limitations for “any offense” involving fraud and the US government during times of war.

So for the period where the US government was at war, the normal six-year qui tam statute of limitations “clock” wouldn’t be running. This could drastically extend the amount of time someone has to bring a qui tam lawsuit. For instance, if an alleged fraud took place on August 8, 2005, and the United States was at war from August 8, 2006 to August 8, 2012, a relator might have until August 8, 2017 to bring a qui tam lawsuit. This means that the qui tam lawsuit would end up starting 12 years after the alleged fraud.

A few years ago, the United States Supreme Court ruled that the Wartime Suspension of Limitations Act did not apply to the six-year qui tam statute of limitations of the False Claims Act. Instead, the United States Supreme Court only applied the Wartime Suspension of Limitations Act to criminal prosecutions, not civil prosecutions. Therefore, the above hypothetical where a relator could begin the qui tam lawsuit up to 12 years after the alleged fraud would not be permissible by law.

The “First to File” Deadline

While the statute of limitations is the “official” deadline for filing a whistleblower qui tam lawsuit, there’s another deadline to consider.

To bring a qui tam lawsuit, there can be no other pending qui tam lawsuit based on the same set of facts. The purpose of the qui tam lawsuit is to make the government aware of a specific fraud, put a stop to it and recover any damages it might deserve. But if a qui tam lawsuit is already pending concerning a specific fraud, the government receives no benefit if a second qui tam lawsuit begins.

Therefore, an individual thinking about filing a qui tam lawsuit could very well have a deadline less than six years from the date of the alleged fraud if someone else is about to file their own qui tam lawsuit.

Let’s say an alleged fraud occurred on February 10, 2017. Several people are aware of the fraud and have plans to file a qui tam lawsuit. The practical deadline for filing a whistleblower qui tam lawsuit could be just a few months, depending on how quickly other individuals file their qui tam complaint with the court.

Worried About a Possible Deadline for Filing a Whistleblower Qui Tam Lawsuit?

If you are considering bringing a qui tam lawsuit, you need to act as quickly as possible. Even if the six-year statute of limitations deadline is years away, there could be someone else who files a qui tam lawsuit before you that deals with the same alleged fraud.

If you have a possible upcoming deadline for filing a whistleblower qui tam lawsuit, you should contact the Bothwell Law Group as soon as possible by calling 770-643-1606.

Who Can File a Qui Tam Action?

file a qui tam action

file a qui tam actionFiguring out who can file a qui tam action is usually straightforward. However, there are several instances where certain limitations will prevent a particular individual or group of individuals from being allowed to file a qui tam action or otherwise recover a reward for exposing fraudulent activity against the federal government.

Who Can File a Qui Tam Lawsuit?

Qui tam actions are legal suits where someone brings a lawsuit against a defendant on behalf of the federal government. Usually, the defendant in a qui tam lawsuit is a corporation. Under the False Claims Act, the “relator” is the person (or whistleblower) who brings the qui tam lawsuit. Relators can include a wide range of individuals and organizations, including:

● Public interest group
● Corporation
● Private organization
● Unions
● Contractors and subcontractors
● Former employees
● Private employees
● State governments
● Local governments
● Public employees, including federal government employees

Most of these entities or individuals acting as relators aren’t that controversial, but a few are. One of the most contested groups of relators includes those who are federal government employees. This is controversial because of potential conflicts of interest and the issue of whether a federal employee should profit from inside knowledge it may obtain throughout the course of duties as a federal employee. Courts are very hesitant to allow federal employees to line their pockets based on information they’re supposed to be finding as a part of their job.

Sometimes, federal employees can act as relators, but they end up losing their qui tam case because they’re not able to meet other qui tam requirements, such as the public disclosure requirement that requires the knowledge provided by the relator be information that is not otherwise available to the general public. Many corporations have served as a relator, but have later lost their qui tam lawsuits because they are unable to meet the public disclosure requirement.

Generally speaking, most relators are employees or former employees of corporations who are doing business with the federal government.

Who Isn’t Allowed to File a Qui Tam Action?

The False Claims Act specifically identifies several situations or limitations on who can file a qui tam action. The first restriction involves relators who received a conviction in a criminal court related to the very fraud they are trying to report. Essentially, the False Claims Act will not allow someone to profit from their own wrongdoing.

A second restriction comes up after filing a qui tam lawsuit. When someone else is first to file a qui tam lawsuit, other qui tam lawsuits cannot go forward. These not-first-to-file whistleblowers are unable to file a qui tam lawsuit and are not allowed to take advantage of situations where someone else did all the whistleblowing legwork.

There is also a blanket restriction for anyone filing a qui tam lawsuit when the federal government is already involved in litigation concerning the alleged fraudulent activity. The federal government isn’t eager to reward whistleblowers who are providing information about false claims and fraud that the government is already aware of and is in the act of prosecuting.

Another blanket restriction exists if the qui tam lawsuit uses information already released to the general public. This is the public disclosure requirement. However, if the relator was the “original source” of the information that is now public, the relator will still be able to continue the qui tam lawsuit.

Who Are Common Qui Tam Defendants?

Many qui tam lawsuits are against government contractors, subcontractors, medical providers, and state and local government entities. Theoretically, almost any individual or person who receives money from the federal government in a business transaction can be subject to a qui tam lawsuit.

General contractors can also be liable for the False Claims Act violation of their subcontractors even if the general contractor did nothing wrong. Public policy emphasizes that general contractors must be responsible for the wrongs of their subcontractors to help protect the federal government from fraud (many subcontractors often have very little money for the federal government to recover in any False Claims Act lawsuit) and encourage general contractors to carefully choose their subcontractors.

What Is the Public Disclosure Requirement to File a Qui Tam Action?

The purpose of the public disclosure requirement is to prevent relators from collecting a reward based on information they had little involvement in providing to the federal government. Another qui tam lawsuit requirement related to the public disclosure requirement is the original source requirement. The original source requirement states that the relator must be a person who has independent knowledge of the alleged fraud that comes from no other source or otherwise substantially adds to already public information.

Contact Bothwell with Your Questions about How to File a Qui Tam Action

If you’re wondering whether you’ll be able to file a qui tam action, get the answers you need by contacting the Bothwell Law Group by calling 770-643-1606.

What Are Qui Tam Actions in Healthcare?

qui tam actions in healthcare

qui tam actions in healthcareQui tam actions in healthcare make up a significant portion of the qui tam lawsuits brought by private individuals. This shouldn’t be surprising given the staggering size of the healthcare industry in the United States and the government’s need for healthcare services. The armed forces, Medicare, Medicaid and the Affordable Healthcare Act are just a few of the major examples of qui tam actions in healthcare.

What Is a Qui Tam Legal Action?

A qui tam legal action is where a private individual, called the relator, sues on behalf of the government. In the United States, the qui tam action falls under the False Claims Act.

Under the False Claims Act, anyone who defrauds the federal government can be liable for hefty financial penalties. Since much of the fraud against the government goes undetected, the enforcement of the False Claims Act relies heavily on whistleblowers to alert the government to the fraud and provide critical information as to what’s going on, who’s doing it, how long it’s been going on, etc. Almost three-quarters of all False Claims Act enforcement lawsuits are the result of a whistleblower first bringing the lawsuit through a qui tam legal action. If it weren’t for these whistleblowers, much of the money recovered by the federal government would not be possible.

Healthcare Spending by the United States Government

A qui tam lawsuit will work with healthcare company violators just as it would if the violator was any other company or government contractor. However, qui tam actions in healthcare are particularly notable for one reason: significant amounts of money are at stake.

There is a lot of money in the healthcare industry in the United States. One of the largest expenditures of the US government is paying for medical care of its citizens. For example, about 4% of the United States entire GDP (Gross Domestic Product) goes to Medicare and Medicaid programs. The GDP of the United States was about $18 trillion dollars in 2015. This means that in the Medicare and Medicaid programs alone, the federal government is spending hundreds of billions of dollars each year. That provides plenty of opportunities for unsavory companies and individuals to try and cheat the system and defraud the federal government. And we haven’t even discussed healthcare services for the military, the Affordable Care Act and Social Security benefits.

Qui Tam Actions in Healthcare

Another way that qui tam actions in healthcare are notable is because of the potentially high amounts of recovery that are possible under the False Claims Act. Punishment of a violator will consist of two components.

The first component deals with actual damages suffered by the federal government. The False Claims Act violator will pay three times the amount of actual damages. For instance, if a hospital overcharges the government by $1 million, it would have to pay $3 million in damages.

The second component deals with penalties for each false claim submitted to the government. Currently, each claim carries a penalty of anywhere between roughly $11,000 and $22,000. This amount can also go up each year as a result of inflation. When healthcare fraud occurs, it usually occurs many times.

Looking at the earlier example of a hospital overcharging the federal government $1 million of medical care, let’s further assume that the $1 million involved the treatment of 10,000 patients. This amounts to 10,000 instances of fraud against the federal government. Since each instance of fraud is subject to between $11,000 and $22,000 in penalties, the hospital may face anywhere from $110 million to $220 million in penalties. This is on top of the $3 million it must pay in damages.

Even though the fraud amounted to “only” $1 million or $100 per patient, the hospital must now pay at least $113 million in penalties and damages for its False Claims Act violations. Since the qui tam provisions of the False Claims Act allow relators to recover anywhere from 15% to 25% of the amount ultimately recovered by the federal government, relators have the potential to receive a very substantial reward. In certain instances, this reward can be as low as 10% or as high as 30%. Looking at the hospital hypothetical, a relator could potentially recovery anywhere from $11 million to $66 million.

But before you decide to go on a whistleblowing crusade to get this type of reward, understand that these rewards are relatively rare and may take many years to obtain. On the other hand, understand that this hypothetical isn’t too far-fetched, either.

Many of the largest False Claims Act recoveries have been in the healthcare industry. Take for instance the top 20 largest pharmaceutical company legal settlements in the United States, which ranged from $345 million to $3 billion – only two of them did not involve the False Claims Act.

Do You Have Questions about a Qui Tam Lawsuit In Healthcare?

Qui tam actions in healthcare can be quite complicated with all of the money at stake. If you think you may want to report healthcare fraud against the federal government, learn more by contacting the Bothwell Law Group.

Why You Need a Qui Tam Lawyer Specifically for Your Case

qui tam lawyer

qui tam lawyerA qui tam lawyer is a unique legal professional experienced enough to handle a unique type of lawsuit. Most lawyers focus on particular types of law or litigating certain types of lawsuits, and qui tam lawyers are no different. Therefore, if you’re thinking about starting your whistleblower lawsuit and need a lawyer, you’re best off hiring a qui tam attorney.

Qui Tam Lawsuits Are Unique

Qui tam lawsuits are special, not just because of the legal issues, but the procedural rules and processes. For example, unlike most lawsuits where the individual can choose to represent themselves pro se, there is no pro se option for qui tam lawsuits. This is due to the underlying basis of a qui tam lawsuit – the whistleblower is suing a defendant on behalf of the government. Understandably, the government doesn’t want a non-lawyer handling a lawsuit that’s potentially worth a lot of money.

Because a whistleblower must hire an attorney, they may try to save money by finding someone who’s not familiar with qui tam litigation. This is a very unwise thing to do. In certain areas of the law, lawyers can take on cases new to them; that’s because the lawyers are only required to learn new law. Most of the other court rules and procedures remain the same. This means the attorney can dabble in an unfamiliar area of the law and still provide high-quality legal services.

For lawyers who don’t normally practice qui tam law, they must not only learn a new type of law, but court rules and procedures, too. While some lawyers may be able to learn the law and court rules necessary to successfully present a client in a qui tam lawsuit, they will need to do a lot of “learning on the fly.” This results in the lawyer not being able to provide the best possible legal representation possible. If a whistleblower chooses an attorney that has to learn on the fly, they’re almost assured a lower quality of legal assistance than if the whistleblower hired an attorney who specifically handles qui tam cases.

Other Reasons a Qui Tam Lawyer Should Handle Your Case

Because many qui tam lawsuits take years to complete, potential whistleblowers must find a lawyer who has the resources and patience to see a case through for decades. Most lawsuits don’t last that long, but a qui tam lawsuit taking several years to complete is quite common. A qui tam lawyer understands this and will, therefore, have the resources and ability to pursue the case for the long haul.

A second reason for using a qui tam lawyer to handle your case is their relationship with the government. Since getting the government to take on your case is so important for its chances of success, it’s nice to hire an attorney who can communicate effectively with the government officials who will decide whether to take on the case for the government.

A good relationship will also be useful should the government choose to take on your case. This is because even though the government will take a lead role once they decide to “intervene,” they will need your assistance and cooperation for the majority of the lawsuit. Having a qui tam lawyer will make this cooperation as smooth and effective as possible.

A third reason to look for a qui tam lawyer is that they’re more able to assess the chances of success. As mentioned previously, qui tam lawsuits can take a long time. Add the fact that one of the major motivations for starting a qui tam lawsuit is the reward, and it’s easy to understand how accurately predicting the success of a lawsuit is very useful.

While no lawyer can predict the outcome of a lawsuit with 100% accuracy (and in fact, the professional and ethical rules usually prohibit lawyers from making definite predictions), a lawyer who works in the qui tam area of law can provide a clearer picture regarding what to expect and the chances of success.

A fourth reason to choose a qui tam lawyer is for their help with gathering evidence. Due to their experience with qui tam lawsuits, they can provide the best advice when it comes to gathering additional documents and information to help your case and allow the government to fully investigate the fraud.

Need a Qui Tam Lawyer?

If you think you may have a qui tam lawsuit, you’re going to need a qui tam lawyer. You can find one by contacting our skilled attorneys at Bothwell Law Group by calling 770-643-1606 now.

What Is the Qui Tam Lawsuit Process and How Long Does It Typically Take?

qui tam lawsuit process

qui tam lawsuit processThe qui tam lawsuit process is very involved and can take a long time to complete. However, it serves as an effective method of finding fraudulent activities and provides a primary way for the government to learn of fraud and prosecute the fraudsters to the full extent of the law.

What Is the Qui Tam Lawsuit Process?

The qui tam lawsuit process is the legal process by which a whistleblower can sue a defendant (usually a government contractor that receives government funding) and allege the defendant is defrauding the government. Normally, it would be the government that would bring this type of lawsuit, but because most fraud against the government is unknown, the whistleblower (called a “relator”) will bring the lawsuit on behalf of the government.

In return for taking on the lawsuit, the government will allow the whistleblower to have a percentage of the money recovered in a successful qui tam lawsuit. This percentage is typically between 15% and 30%.

The qui tam lawsuit process begins with getting an attorney, preferably one experienced in qui tam lawsuits. Qui tam lawsuits are complex and require unusual legal procedures, so finding a qui tam lawyer is important. When looking for a qui tam attorney, whistleblowers need to be very careful to find one qualified in handling qui tam cases, given what’s at stake.

After hiring the right attorney, the first step in the qui tam process is filing a complaint, just like a typical lawsuit. But unlike most lawsuits, qui tam lawsuits require filing in federal district court, not state court. Also, the complaint must be “under seal,” which means it remains secret. This means the defendant doesn’t know about the lawsuit, nor does the general public know a lawsuit is pending against the defendant. With normal lawsuits, the filing of a complaint is public, and the defendant knows about the lawsuit almost immediately.

In addition to filing a complaint, the whistleblower will also need to submit a disclosure statement. This statement sets out all the evidence the whistleblower has that supports the allegations that the defendant has defrauded the government. This disclosure statement is important because it provides a starting point for the government’s investigation into the alleged fraud.

Once the complaint is in the court system and the disclosure statement provided, the government will investigate the fraud allegations. This usually takes a few months to a few years. While this investigation is taking place, the lawsuit will not move forward.

After the government finishes its investigation, it will decide whether to intervene, or join the lawsuit. The decision to intervene is critical to the success of the qui tam lawsuit. Most qui tam lawsuits where the government doesn’t intervene aren’t successful, and it’s easy to see why. Having the full resources of the United States government means a much stronger legal action for a much longer amount of time.

Additionally, when the defendant sees that the government decided not to join the whistleblower in a lawsuit, it sends a strong signal that the whistleblower doesn’t have a solid case. This means it’s more likely the defendant will fight the qui tam lawsuit and less likely it will want to settle.

Once the government decides to intervene (or not), the court lifts the seal on the qui tam lawsuit and the case can proceed. The lawsuit is now public and the defendant is aware of it.

If the government has decided to intervene, it will often try to settle the case with the defendant. Most qui tam lawsuits end in settlement and do not go to trial.

How Long Does the Qui Tam Lawsuit Process Take?

Unfortunately, there is no sure answer to this question. There are many variables, such as the strength of the lawsuit, who the defendant is, whether it goes to trial (or settles), whether it’s appealed, how complex the fraud is and how long the government needs to investigate the fraud allegations.

After a complaint is under seal, the government has at least 60 days to conduct its investigation and decide whether it will intervene. However, most of the time, the government receives extensions and will take as much time as it needs to conduct its investigation. This can take anywhere from a few months to a few years.

Then assuming the government decides to intervene, the lawsuit can proceed. The government contacts the defendant and tries to negotiate a settlement. In the absence of a settlement, the lawsuit will proceed like a typical civil lawsuit. This means it can take years before trial and after the trial, it could be another few years while the case is on appeal.

So what’s the bottom line? A qui tam lawsuit can take anywhere from a few months to decades. However, most whistleblowers who start their qui tam lawsuits should expect it to take several years, at least.

Questions about the Qui Tam Lawsuit Process?

Learn more about the qui tam lawsuit process by contacting the Bothwell Law Group.

9 Tips for Whistleblowers from Experienced Qui Tam Law Firms

experienced Qui Tam Law Firms

experienced Qui Tam Law FirmsWhy should you go to an experienced qui tam law firm when you are building a whistleblower case? When you need to get something done right, you want advice from the experts, right? If you’re looking to invest in stocks, you find a Wall Street broker for the best tips. If you’re redecorating your home, you call a top designer. If you’re building a whistleblower case, you look to experienced qui tam law firms for tips.

Are you considering a whistleblower case? Keep in mind these nine tips from Bothwell Law Group:

1. Get a qualified attorney.

The single most important thing you can do as a whistleblower is to hire an experienced attorney. You need a lawyer familiar with the whistleblower laws and one who is familiar with the entire process. Not only can a good attorney help you determine if you have a whistleblower case, but he will keep your best interests in mind throughout the whole process.

Your employer will look out for their protection, and the government’s prime concern is the recovery of the assets fraudulently taken from them. Hire a qualified attorney who knows all the ins and outs of whistleblowing to help you protect your job and recover your reward.

2. Keep copies.

When you bring evidence of the fraud to either your employers or to the attorney general, make sure you keep copies of everything. You may never need them, but if you do, they’re invaluable. Also, keep copies of any positive remarks about your employment, such as reviews and recommendations. These are important if your employer attempts any retaliation disguised as a work performance issue.

3. Document everything.

If you’re considering building a whistleblower case, it’s imperative to document everything you can. Keep track of dates, conversations between involved parties, appointments that might be pertinent and anything else that might be related to the fraud. Keep a hard copy of everything, not just a digital copy. If your only documentation is on the computer and something happens to your hard drive, you will be left with nothing

4. Report to authorities promptly.

Once you’ve determined that fraud is going on, you need to report it, face to face, to the attorney general of your state. There are statutes of limitations for whistleblower cases. Also, only the original reporter is eligible for a reward. By delaying too long, you are taking the chance of someone else reporting the activity, and you lose any opportunity for the reward of up to 15%-25% of the amount of money recovered.

5. Save some cash.

Whistleblower laws protect you against any retaliation at your job. According to the law, you cannot be fired or passed over for promotions or wage increases. Harassment, in any way, including a change in hours, benefits or status, is against the law. Although the law is clear, that doesn’t mean your employer won’t try to dismiss you, forcing you to fight legally to get it back. If you can save some money before moving ahead with your suit, you will eliminate a significant amount of stress.

6. Keep it quiet.

Whistleblower cases are kept under seal while the government investigates the case. The seal means everything is kept anonymous and private. You are not allowed to discuss any of the particulars of your case, or even the fact that an investigation is taking place. Don’t risk the situation by speaking about it to the press or anyone else until the court seal is removed.

7. Be specific.

You’ve heard the adage about the three most important things in real estate being location, location, location. In a whistleblower case, it could be said the three most important things are specifics, specifics, specifics. Keep track of exact dates, timecards, participants in phone conversations or meetings, dollar amounts, billing dates, and any other details you have. The more specifics you provide, the tighter your case will be.

8. Be careful about whom you trust.

Whistleblowing is not something to take lightly. It’s a matter of felony fraud at a federal level, which can mean serious prison time and hefty fines if proven to be false reporting. Many times, the scam involves a significant number of people cooperating for a payoff. Be extremely careful whom you trust – especially at your job. You can’t be sure who might a part of the illegal activities – or who might blow the whistle on you and your suspicions. Make certain that what you think is happening actually is. Get copies of evidence and keep them offsite, never at work.

9. Don’t sign anything.

You may decide to bring your allegations to your employer before you go to an attorney. Many companies have specific procedures set up for reporting fraudulent activity or any other criminal behavior. Should you choose to do this, make sure you do not sign anything indicating an agreement to refrain from a lawsuit or showing any financial compensation in return for dropping the allegations. Not only will this eliminate any possibility of you receiving your rightful share of the recovered money, but it could also implicate you legally. Don’t sign anything until you show it to your attorney.

It’s possible to build a compelling qui tam case resulting in both knowing you helped right a wrong and receiving a potentially substantial reward. The first step is finding a law firm that knows how to help you. Visit us Bothwell Law Group online to learn more about the benefits of working with experienced qui tam law firms.

What Does a Health Care Qui Tam Attorney Need to Prove a Case?

health care qui tam attorney

health care qui tam attorneyA health care qui tam attorney needs a case that involves a direct party—usually an employee or former employee—bringing a case of fraud against the government. It’s a case filed under the False Claims Act, which was developed to protect the government against fraud. Many circumstances leading to fraud involve

Medicare or Medicaid, both of which are federally regulated programs to pay for medical services. Health care qui tam cases can also include nursing home fraud, pharmaceutical fraud, medical device fraud, hospice or home health fraud and healthcare scams.

Here are a few examples of health care fraud activities that might be involved:

  • Billing for services not provided
  • Billing for more expensive services than the ones performed
  • Delivering more expensive services than were medically needed
  • Misrepresenting the diagnosis to justify payment
  • Creating false documentation to support payment
  • Billing under the provider number of a different doctor than the one who performed the procedure
  • Performing medical procedures without a physician supervising
  • Backdating procedures for a time the patient was insured
  • Kickbacks and Stark Law violations
  • Billing for “overflow” of medicine
  • Off-label marketing of pharmaceuticals

You may wonder if the information you have is enough to file a health care qui tam case. While every case is individual, knowing the basics of what an attorney needs to prove a case could help you determine if you’re heading in the right direction.

It’s like packing for the family summer vacation. If you leave everything to memory and guesswork, you’ll likely forget something important. If you make a list of all the essentials, you stand a much better chance of getting to where you’re going with everything you need. You know that will save you time- and probably a whole lot of hassle and expense than if you just pack off the cuff.

Here are some things your health care qui tam attorney needs to prove a case:

Your Health Care Qui Tam Attorney Needs to Know the Timeframe

One of the first things to knock off your qui tam case checklist is when the fraudulent activities took place. There is a statute of limitations of six years in false claims acts. Some circumstances fall outside this boundary, but your attorney needs to know when the fraud took place.

Documentation of dates can be one of the most powerful pieces of evidence in a health care qui tam case. This record will serve to prove the timeframe is within the statute of limitations.

Your Health Care Qui Tam Attorney Needs to Have Credible Information of Fraud

You may be aware of fraudulent activity at your place of employment due to your expertise and experience. Your health care qui tam attorney will talk with you about the information you are aware of and help determine if it is credible enough to provide the basis of a case. This information may be verbal, or you may have physical evidence. Physical evidence is tricky and can be difficult to obtain. Talk with an attorney who is knowledgeable about false claim act suits and he or she will be able to determine the credibility of what you know.

When you meet with your health care qui tam attorney, bring any proof you have as evidence of the fraudulent act. Your evidence can include things like receipts, copies of fraudulent paperwork or bookwork and other items that may be in your possession. Your attorney will have a staff to investigate and gather evidence and will assist you in determining if that evidence is sufficient for a qui tam case.

Your Health Care Qui Tam Attorney Needs to Determine If You Are an Original Source

Only one person can bring a particular qui tam case. If the fraud has already come to the attention of the government, you cannot bring a separate case. Your attorney will research and find out if you are the original source of the alleged fraud. Your information comes from inside information, if you are the primary source, not from something you read about or heard about somewhere else.

Your Health Care Qui Tam Attorney Needs Knowledge to Prove a Case

It’s important to choose an attorney who knows qui tam law in the health care field. The details matter in any lawsuit and with qui tam cases there are an awful lot of rules and regulations governing every aspect of the process. Also, if the government chooses not to intervene, you need an attorney with the wisdom to know if you should proceed on your own or not. Choose an attorney who has successfully argued health care qui tam cases in the past, so you can trust he or she will make solid decisions.

Learn more about the benefits of using a health care qui tam attorney by contacting the Bothwell Law Group online.

The Top 5 Things You Need to Know About Qui Tam Suits Before You Proceed

Qui Tam Suits

Qui Tam SuitsIf you are considering blowing the whistle on unethical or fraudulent activities, you are likely aware of qui tam suits. A qui tam lawsuit is brought by an individual who possesses knowledge of the fraudulent activity and brings a lawsuit on behalf of the government to recover stolen funds. Once the government has conducted its own investigation, it can choose to join the litigation.

What Is a Qui Tam lawsuit?

Qui tam suits (pronounced ‘kwee tom’ or ‘kee tam’) are suits brought up under the qui tam provision of the False Claims Act. Unlike most lawsuits where the party bringing the suit has been injured in some fashion, qui tam suits are brought by an individual who has not been directly harmed by fraudulent behavior

The individual bringing the suit -referred to as a ‘relator’- is encouraged by the government to come forward with information about fraud levied against the government. This allows the government to conduct its own investigation, and potentially to recover stolen funds should it decide to join in on the relator’s lawsuit.

If this litigation is successful, the relator is often entitled to a small cut of the funds recovered by the government; this is due to the government not being aware of the fraud had the relator not come forward.

What Types of Cases Qualify as Qui Tam?

Under the False Claims Act, individuals and companies who defraud the government are liable for the amounts they are unlawfully paid. With very few exceptions, contractors are liable for fraud involving federal programs and contracts. This can include the following:

  • Improper billing for Medicaid or Medicare. This can include overbilling and billing for services, procedures, or equipment that were not rendered.
  • Overcharging for goods or services that were provided under a government contract.
  • Requesting payment for goods and services not provided.
  • ‘Off-label’ marketing of FDA-approved drugs. ‘Off-Label’ refers to prescribing medications to treat health issues they were not designed to address, nor tested to treat by the FDA.
  • Grant recipients who charge the government for expenses not related to the grant rewarded.
  • Accounting fraud.
  • Bribing of foreign officials.
  • Manipulation in trading of securities or commodities.

Qui Tam – What Does It Mean to be a Whistleblower?

A whistleblower, also known as a ‘relator’, is an individual who has witnessed fraudulent activity and chooses to report it to the government. Unlike the way it’s depicted in television and movies, anyone from any background can blow the whistle on companies who are defrauding the government. However, becoming a whistleblower and going public with accusations of fraudulent behavior can adversely affect a person’s professional and personal lives, so it should be approached cautiously with the advice of an attorney.

Call (770) 643-1606 to find out more about qui tam suits by contacting Bothwell Law Group online.

The Most Common Qui Tam Actions and Why You Should Know About Them

Qui Tam Actions

Qui Tam ActionsIf you don’t have the slightest idea what qui tam actions are, don’t worry; we will break it down for you in this blog post. To understand qui tam, we first have to have a basic understanding of the False Claims Act (FCA.) Essentially, the FCA is a law that says it is a crime for any person or organization to attempt to defraud the U.S. government by submitting, or being involved in the submission of, false or fraudulent claims, documents or statements, in an attempt to receive payment or to lower or eliminate an obligation to make payments to the government.

The qui tam provisions in the FCA encourage whistleblowers to come forward and to bring to light any actual or suspected violations of the FCA’s provisions. The qui tam statute was added to the existing law in 1986. Basically, qui tam actions are actions brought in federal court by private citizens against individuals or organizations that are suspected of having violated the False Claims Act (FCA.)

In some cases, these private citizens are then entitled to recover up to 30% of the total damages recovered in the case, in addition to recovering payment for their legal fees, and being afforded protection under the FCA for retaliatory actions taken by their employer (or former employer). The government can choose to intervene in a qui tam action, joining as a party. If the government decides not to intervene, the private citizen can still continue the action alone.

What Are the Most Common Qui Tam Actions?

Although there are many reasons for filing FCA qui tam actions, most of them fall under one or more of the following circumstances:

  • Knowingly submitting false or fraudulent records or statements to the government.
  • Knowingly submitting false benefit certifications to the government.
  • Knowingly overcharging or mischarging the government.
  • Intentionally billing the government for services not provided. Many of these claims often arise from billings related to medical services for which the patient was billed for more expensive services not received.
  • Submitting Reverse False c Traditional FCA claims are filed because a person or organization filed a false record, document or statement in order to fraudulently obtain payment from the government. In a reverse false claim, a person or organization filed a false record, document or statement in order to “conceal, avoid or decrease an obligation to pay or transmit money or property to the Government.” (31 USC § 3729(a)(7).
  • Other actions that lead to stealing from, cheating or defrauding the g

Are Qui Tam Actions Limited to Current Employees?

No! A qui tam action can be filed by anyone who has knowledge of or information about a false or fraudulent claim or statement having been provided to the government in an attempt to obtain payment, or to decrease an obligation to pay. If you think you might have a case, it’s best to schedule a consultation with an experienced qui tam attorney who can help you determine whether you should move forward.

Qui tam actions are often filed by current employees of a company accused of violating the FCA, but these actions are not limited to current employees. Other parties often include former employees, subcontractors or temporary employees, competitors, employees of state, local or federal governments as individuals, state and local government employees on behalf of their government employer, corporations, private organizations and public interest groups.

As long as the individual bringing the qui tam action has knowledge of wrongdoing, they can blow the whistle and bring suit on the government’s behalf. Making the decision about whether to file a case can be rather involved. There are considerations you may not be aware of on your own, but your attorney can help you understand what’s at stake, what to expect, and what you might stand to gain if your case is successful.

When Should You Involve an Attorney?

If you are considering filing a qui tam action against your employer, it is important to talk to an experienced whistleblower attorney who can help you evaluate the strengths and merits of your claim. You should also talk to an attorney if you have brought your concerns to your employer’s attention already and have been the victim of any sort of harassment or other retaliatory action. You don’t have to go through this alone.

Find out what you need to know about protection against qui tam actions by calling 770.643.1606. The experienced fraud attorneys at Bothwell Law Group work exclusively on whistleblower and qui tam actions and will advocate vigorously for you.

Breaking Down the Qui Tam Lawsuit Definition So Anyone Can Understand It

Qui Tam Lawsuit Definition

Qui Tam Lawsuit DefinitionAre you searching for information to learn more about a qui tam lawsuit? It’s a rather complicated legal topic, but we will do our best to break it down for you in layman’s terms. Keep reading for the details you need to know if you are considering or involved in a qui tam lawsuit.

Under the False Claims Act, the qui tam law allows a private party to bring a claim against another party for false billing to the federal government or for withholding information resulting in a higher cost to the federal government.

Qui Tam Lawsuit: When to Litigate

The federal government always retains the right to take on a false claims case and pursue it first. However, where the Department of Justice decides that a case is not a priority to pursue, then the reporting party can bring a lawsuit at his cost and charge the false claim defendant in federal civil court.

If the reporting party wins the case, he would then be eligible to between 15 and 25 percent of the total recoveries due to the federal government. While this may sound like a small amount, it’s frequently the case that the erroneous cost amount covers multiple years and hundreds of billings.

Qui Tam Is Not Necessarily Whistleblower Protection

The qui tam provision of the False Claims Act is frequently confused with being a whistleblower protection clause, but they are not the same. Whistleblower protections help ensure a reporting party is not unfairly retaliated against in their career or life from reporting. The qui tam provision, however, provides whistleblowers with the ability to carry out a lawsuit penalizing a wrongdoing defendant. The protection law is related, but separate.

The basis of the qui tam lawsuit option started as far back as 1899 under an obscure law known as the House Refuse Act. However, under British common law, the concept was in play up to four centuries earlier. The early U.S. law was one of the first allowing lawsuits by private parties to enforce the provisions of the related federal law.

Qui Tam Lawsuit Options and Benefits

The benefit of the Qui Tam option is twofold. First, it allows the Department of Justice civil branch to prioritize its cases without completely missing the opportunity to pursue a matter of concern. Often a report may seem to be serious, but the evidence is insufficient for the federal government to pursue.

Another possibility is that the Department of Justice branch is overwhelmed and focused on much bigger cases already, being unable to spare resources for the latest report. The Qui Tam option allows the reporting party to pursue the matter in court to the benefit of the federal government. This keeps the issue alive and ensures that a wrongdoing party still ends up being held responsible. It also works as an active deterrent to intentional financial wrongdoing.

From the defending company perspective, the Qui Tam option is a dual exposure for liability. Again, either the Department of Justice or the reporting party can sue the company. Both options can result in significant damages if wrongdoing is proven and confirmed in court. And similar to other false claims charges, how a company responds when incorrect actions or wrongdoing are identified makes a big difference in the outcomes legally.

The qui tam lawsuit is a serious step and should be handled with sensitivity. To better understand how to proceed in a quit tam lawsuit, contact our team at Bothwell Law Group.

Who Handles the Qui Tam Claims Process, and Where Do I Start If I Have One?

Qui Tam Claims Process

Qui Tam Claims ProcessThe qui tam claims process can be a complex exercise. Every case is unique and needs to be handled in a slightly different way. The process is also very specific; any variations or deviations from the appropriate procedure can end your suit before it even starts.

With this in mind, we’ve gone ahead and outlined some general guidance for processing qui tam cases, as well as advice to potential whistleblowers on where they should start. We hope you find it useful in your investigation!

Where to Start: Hiring a Whistleblower Law Firm

Remember when we said qui tam cases were complex and unique? They play by an entirely different set of rules than regular litigation, requiring a law firm with the skill, experience, and know-how to ensure you have the best possible chance of reaching a successful conclusion.

Once you’ve settled on a few prospective firms, look at each one carefully and assess them based on the following:

  • Experience in similar cases
  • Understanding of the particulars of your case
  • Honest and thorough assessment of your prospects
  • Clear outline and understanding of next steps and how to proceed
  • A good working rapport between the two of you

All of these will be critical to successfully surviving what’s to come.

Next Up: Building the Narrative and Filing Suit

This step is where your legal team will document all the information available, and begin crafting it into a graphic and compelling story. The goal is to send a persuasive argument and abundance of initial proof to the government, sparking further investigation. Depending on the strength of the material and content, the government will then decide whether to take over the case themselves, or let you proceed further on your own.

Further Investigation and Interviews in Your Whistleblower Case

Once the complaint is filed, your attorneys will continue to gather evidence, monitor the case progress, and work with the Department of Justice to keep your case moving along. This will likely include an interview between the whistleblower and the government, where the government will determine how effective and compelling the individual’s story is. The right legal team will help you prep for the occasion, and be with you every step of the way.

Patience and the Waiting Game for Whistleblowers

Whistleblower cases can take years to develop. During this time, you will be prohibited from talking to anyone about the case, outside of the government, your legal team, and anyone else sanctioned by the DOJ. In general, you can expect to wait up to two years for the government to make an ultimate determination regarding whether or not they will take over the case – also called intervening or joining.

If they decide not to join, you and your attorneys will need to make a decision regarding whether or not you wish to press forward with your case anyway. An experienced attorney should be able to tell you what the odds are, and make a recommendation that’s in both parties’ best interests.

Going to Court with Your Whistleblower Case

If you decide to go to trial, the court case will proceed normally from this point on. At the end of the process, the court will rule on whether your case is valid, and also the percentage of the recovery to which you will be entitled.

Good luck!

Want to Learn More about the Qui Tam Claims Process?

You can find out more about the qui tam claims process by contacting Bothwell Law Group online. We’ll be happy to answer your questions as you make your decision about moving forward with your claim.