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False Claims Act - Qui Tam Actions

Maryland/ Washington, D.C., False Claims Act Lawyer - Qui Tam Actions Attorney

What is the False Claims Act?

The False Claims Act is an act that gives private litigators the legal right to file a civil law suit on behalf of the United States federal government’s against a private individual or company for actions consisting primarily of fraud. Initially, the False Claims Act primarily dealt with Medicare fraud, however, the act was expanded to actions involving education grants, housing programs, emergency relief programs, defense contracting, false certifications of compliance with environmental laws and other kinds of fraud.

According to the act, 31 U.S.C. § 3729 et seq., any person or entity cannot: (1) knowingly present or cause to be presented to the Government a false claim for payment; (2) knowingly make, use, or cause to be made or used, a false record or statement to get a false claim paid or approved by the government; (3)conspire to defraud the Government by getting a false claim allowed or paid; (4)falsely certify the type or amount of property to be used by the Government; (5 ) certify receipt of property on a document without complete knowledge that the information is true; (6) knowingly buy Government property from an unauthorized officer of the Government, or; (7) knowingly make, use, or cause to be made or used a false record to avoid, or decrease an obligation to pay or transmit property to the Government.

Typically, the actions involved can consist of things like double billing, charging for services never performed, waiving co-payments, or someone other than the patient’s doctor completing significant medical documents such as a Certificate of Medical Necessity. The private individual, called a “relator” upon a successful litigation, will be entitled to a certain percentage, usually 15%-30% of the federal government’s recovery of losses as a result of the fraud.

What’s the procedure for filing under the False Claims Act?

The relator must have “direct and independent knowledge of the information on which the allegations are based.” Furthermore, the relator must have “voluntarily provided the information to the Government before filing the action. The relator then files an action in the United States Federal District Court which would have jurisdiction over the claim. Once the Court issues a summons, the individual should effectuate service of process by serving the summons and complaint on the Attorney General of the United States and the local United States Attorney office for the subject jurisdiction. A claim must be brought within six years from the date on which the violations of § 3729 were committed or three years after the date when facts material to the right of action are known or reasonably should have been known by the United States official charged with the responsibility to act in the circumstances, but not more than 10 years after the date of the violation, whichever occurs last.

Upon receipt of the claim, the U.S. Federal Government can choose to intervene in the lawsuit, meaning it can decide to take the case over and prosecute the defendant itself. This may provide a great advantage to the relator because (s)he will now have the power of the United States government behind him or her and litigation resources will no longer be an issue. However, when the Government intervenes, the relator, though still a party to the action, loses control of the proceedings and the relator’s reward is limited to between 15 and 25 percent of the government’s total recovery plus reasonable attorney’s fees and expenses. When the government declines to intervene the relator’s share of the award increases to between 25 and 30 percent of the recovery plus reasonable attorney’s fees and expenses.