Whistleblower Claims

Guiding Residents of the Capital District Through Complex Litigation

The federal False Claims Act provides a reward to private persons who act as whistleblowers and come forward with information concerning fraud committed against the federal government. Whistleblowers in False Claims Act cases are called “relators” and are entitled to sue on behalf of the federal government, even if they personally have not been damaged by the fraud. This provision is known as the “qui tam” provision and allows rewards to relators of up to 30 percent of the total amount recovered by the government.

Qui tam comes from the Latin phrase meaning “he who brings a case on behalf of our lord the King, as well as for himself.” Passed during President Lincoln’s era, the False Claims Act and its qui tam provisions have been in effect since 1863. Also known as “Lincoln’s Law” the False Claims Act was enacted by Congress in response to government contractors cheating the government during the Civil War. Qui tam actions have been largely successful in helping the federal government combat fraud such as Medicare- and Medicaid-related fraud and false claims submitted by government defense contractors.

False claims can take many forms, including:

  • Overcharging for a product
  • Duplicate billing
  • Charging for services not rendered
  • Material false statements on a claim
  • Billing for services not rendered in accordance with Medicaid or Medicare guidelines
  • Knowingly receiving improper payments or overpayments without reimbursing the government
  • Failing to comply with program restrictions
  • Many other possible variations

Entities or individuals who submit false claims to the federal government are subject to severe civil penalties including a fine of $5,500 to $11,000 per false claim and treble (triple) damages. The damages can be substantial, with recoveries by the government in excess of $33 billion between 1986 and 2006. In each qui tam action, relators may receive between 15 and 30 percent of the total recovery by the government, whether by settlement or verdict.

The motivation behind the creation of the qui tam provisions of the False Claims Act was the recognition that the government lacks the information to pursue all the false and fraudulent claims that are submitted. Although the government has committed significant resources to combating fraud, including the creation of the Medicare Task Force in 2007, it is estimated that Medicare fraud alone costs taxpayers more than $60 billion each year.

Qui Tam vs. Fraud

Qui tam actions differ greatly from other fraud actions and are extensive and extremely complex. They involve procedural requirements, such as filing the complaint under seal and providing a disclosure statement to the United States Attorney General and United States Attorney where the action is venued that are unique to the False Claims Act and must be followed closely. Furthermore, there are several limitations to filing a complaint as a relator that must be carefully considered prior to beginning an action. For these reasons, it is imperative to obtain an attorney who is experienced in litigating false claims actions and settlements.

For additional information about qui tam or False Claims Act matters, contact our Albany whistleblower claims attorneys for a free confidential consultation.

Dodd-Frank Securities Whistleblowers

The 2010 Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act) added Section 21F to the Exchange Act, providing for whistleblower incentives and protections, similar to the federal False Claims Act. Under the Dodd-Frank Act, whistleblowers may receive awards for reporting original information about securities law violations to the Securities Exchange Commission. These violations include insider trading, accounting fraud, broker-dealer violations, and corporate disclosure violations.

The Dodd-Frank Act also provides confidentiality for whistleblowers who report violations to the Securities Exchange Commission. Whistleblowers are permitted to remain anonymous until payment of the reward, which can range between 10 and 30 percent of the amounts collected by the SEC where its sanctions exceed $1 million. In determining the award percentage, the SEC generally considers the significance of the information, the degree of assistance provided by the whistleblower, and the extent to which the government wants to deter the violations in question.