Demystifying the Qui Tam Process

Are billion-dollar whistleblower lawsuits true magic or just smoke and mirrors?  How do cases start and end and what’s behind the curtain that makes them succeed? The two most important facets of success in qui tam litigation are you, the whistleblower, and your selection of who is the best whistleblower lawyer for your case as only a handful have repeated success in the space, the rest are the ones with just smoke and mirrors.  Luckily, it’s easy to vet qui tam law firms by asking a few simple questions like how many False Claims Act lawsuits has the firm handled, have they ever succeeded in the past, and what cases comparable to your fact pattern have they litigated?  Here we will demystify other elements of the qui tam process as well.  

The Definition and Origins of Qui Tam Lawsuits

Qui Tam Definition

The term “Qui Tam” originates from the Latin phrase “qui tam pro domino rege quam pro se ipso in hac parte sequitur,” which translates to “Who sues on behalf of the King as well as for himself.”

In a Qui Tam action, a relator, or whistleblower, initiates legal proceedings against an entity that’s defrauding the government on behalf of the government. In this context, the government is considered the plaintiff, not the relator, and the plaintiff is known as a relator since he is a surrogate for the government and relating its complaint through the individual’s lawsuit. If the  case is successful, the relator who filed the suit is entitled to receive a portion of the award as a reward for their contribution as a whistleblower award. 

Under the False Claims Actif the Qui Tam action leads to a favorable outcome for the government, the relator may receive a percentage of the government’s award, up to 30%, but typically around 20% if the government intervenes, and 25% if it doesn’t.  Intervention refers to whether the government chooses to advance the case itself or instead passes the torch to your whistleblower counsel to litigate with its blessing.

Qui Tam actions serve as a powerful tool in fighting fraud and corruption against taxpayer’s funds. They incentivize individuals with knowledge of fraudulent activities to come forward and assist in exposing wrongdoing while sharing in the recovery which allocates reward with the risk.

The Three “C’s” to a Successful Qui Tam

Counsel – Qui Tam Counsel

As a whistleblower, one of the most crucial decisions you need to make early on is selecting the right counsel to assist you throughout the process. Here is some vital advice to consider:

• Cases: First and foremost, you should ascertain whether the counsel you’re considering has experience handling cases similar to yours, particularly if Qui Tam cases are a focus of their practice, what their track record of success is and whether they’ve handled a case similar to yours. 
• Competence: It is essential to determine the Qui Tam Counsel’s track record in handling cases like yours and their success rate. An indicator of the future is the success of the past, although nothing is guaranteed and experience in achieving positive outcomes in similar situations may be a sign that they are competent to address your needs and advance your case.  Since False Claims Act qui tams are handled by the Department of Justice it may be advantageous to have a lawyer with a DOJ and/or FBI background on your team to facilitate interfacing with those agencies. 
• Clarity: A reliable whistleblower law firm will provide you with clarity regarding the possible progression of the case and  potential roadmap to success. They should be able to offer guidance based on their experience and knowledge of past cases, including insights into why some cases may have failed, what can make yours succeed and how to advance the case in a meaningful way as well as provide comfort during the long quiet periods of the litigation

Corruption

Clearly identify the wrongdoing you are blowing the whistle on. Whistleblower cases under the False Claims Act typically involve exposing fraudulent conduct that costs taxpayers significant amounts of money. This could include Medicare or Medicaid fraud, where healthcare providers engage in practices like upcoding, false billing, kickbacks, and other schemes that defraud the healthcare system and taxpayers. Some other areas of astronomical fraud include defense contractor fraud, where the contractor is overcharging the government for parts and/or labor or producing non-compliant product and pharmaceutical fraud in which they may be marketing a product off label, providing kickbacks or falsifying their NDA or CGMP compliance. An experienced Medicare fraud whistleblower lawyer can help you thoroughly present the elements and proofs of the fraud.

Communication

Effective communication with your whistleblower team is crucial for the success of your case.. Just like in any aspect of life, successful outcomes depend on open and clear communication. Your counsel should foster a sense of teamwork and help prepare you for speaking with  the government. For instance, a well-prepared relator interview with the government can significantly impact the case’s progress or conversely a poor presentation can crush the case. Your counsel should be open to discussing the entire process with you, from start to finish, ensuring you understand what needs to be proven and how to present the evidence effectively. Equally, you should be candid about what skeletons there are and anything you’re concerned about so your whistleblower law firm can address it with you ahead of time how to handle it. For all you know, what you’re really worried about isn’t really a concern after all. 

Choosing the right Qui Tam Counsel is paramount for the success of your whistleblower case. Look for experienced firms that is knowledgeable in handling similar cases, have a proven track record, offer clarity and guidance, and prioritize effective communication with their clients. With the right representation, you can increase your chances of making a meaningful impact and protecting the interests of taxpayers and society as a whole.

Whistleblower Awards

The False Claims Act incentivizes whistleblowers to come forward, recognizing the professional and personal risks they frequently take to expose and prevent government fraud..  Although the False Claims Act addresses economic fraud against the government, the consequences of the fraud can have a direct impact on people’s lives and sometimes result in patient harm

If the government intervenes and the case is settled or tried successfully, the whistleblower, or relator, is entitled to 15% to 25% of the government’s total recovery as a whistleblower award. If the whistleblower proceeds and succeeds without the intervention of the government, the whistleblower reward ranges from 15% to 30% of the government’s total recovery as a whistleblower reward. 

The Role of Law Firms in Qui Tam Lawsuits

Bringing a False Claims Act case to the Department of Justice involves complex legal analysis and multiple layers of scrutiny, making it far from a simple process for whistleblowers. Determining actionable facts under the False Claims Act and identifying other potential legal avenues requires an experienced lawyer. As whistleblowers navigate this intricate terrain, seeking professional guidance becomes imperative to present a strong case before the Department of Justice, ensuring accountability and justice in the fight against government fraud.

To be eligible for a whistleblower reward under the False Claims Act, it’s not just  crucial to file the case through a whistleblower law firm, it’s essential. False Claims Act cases must be filed through qui tam counsel and can’t be filed without one. Whistleblower law firms experienced in handling these intricate cases and possess the expertise to navigate the legal complexities effectively. By engaging a whistleblower law firm, whistleblowers can ensure that their claims are presented professionally and significantly increase their chances of eligibility for a potential reward if the case leads to a successful recovery.