Whistleblower/Qui Tam

In most cases, the whistleblower lawsuit is filed under seal, meaning it is confidential. After reporting and filing the case, the U.S. federal prosecutors and agents investigate and then decide whether the case will be pursued by the Government. If it is, the whistleblower(s) generally receive a percentage of any money recovered, plus attorney fees. If the case is not accepted by federal prosecutors, the whistleblower may decide to go ahead and pursue the case on his or her own, with assistance of counsel.

For whistleblower cases involving state or local fraud, the process is very similar and the lawsuit is filed as dictated by the relevant state law.  Again, persons filing such suits stand to receive a portion of any recovered damages.

Claims can involve:

• Healthcare claims – includes billing for medical services not provided, intentionally billing for the wrong procedure or for supplies never purchased, or defrauding the government through Medicare and Medicaid overbilling. Healthcare fraud can be perpetuated by pharmaceutical companies, hospitals, nursing homes, ambulance services, as well as by individual doctors, physician’s assistants, or medical administrators who intentionally submit claims for reimbursement based on false information.
• Military spending (defense contractor fraud) –  the United States spends billions of dollars annually on our country’s defense with a substantial portion covering goods and services provided by defense contractors. This makes the government a key target for misconduct. The most common forms of defense contractor fraud include billing for services/products that were not provided, the providing of inferior goods, or bid rigging on government contracts.
• Financial fraud – this type of fraud typically involves a company or bank filing false information or reports with the government.  It can also involve manipulating company stock prices.
• COVID CARES Act fraud – fraud that generally involves false statements to the government to receive Covid-19 benefits or recovery assistance.  It can also include fraud related to the vaccine distribution and vaccine quality.  For example, companies that either sought benefits to which they are not entitled, or a companies or distributors who produce knock-off/fake vaccines and then bill the government.

Other claims – violations of safety rules in the workplace, false tax returns, bankruptcy fraud, etc.  Fraudsters can be very creative, so there is no way to provide an exhaustive list.  If you suspect it is fraud, it probably is.

Have you witnessed or participated in a fraudulent activity?

• Do you have evidence of wrongdoing? Not sure what to do with the information, if anything at all?
• Do you know your rights and protections as a whistleblower?
• Do you know of any fraud against the government?
• Did you report someone’s misconduct to your superiors and get reprimanded or fired?

Most of the time, whistleblowers are trustworthy people working closely with the person or company committing fraud.  Often, a person bringing forward the misconduct claim is at risk for losing their job or career, and sometimes their personal lives are exposed, for doing the right thing.