Whistleblowers and Qui Tam Lawsuits

Whistleblowers Reporting Fraud Can Recover

Individuals who appropriately report corporate fraud are known as “whistleblowers.” When instances of fraud involve federal or state taxes, whistleblowers are entitled to a significant portion of the amount recovered by the government through what are known as qui tam lawsuits. Both federal and state laws provide provisions for whistleblowers to bring these qui tam lawsuits.

Whistleblowers have been instrumental in the recovery of billions of tax dollars under the federal False Claims Act. Similarly, Tennessee’s Medicaid False Claims Act (TMFCA) has targeted the misuse of Medicaid and TennCare tax dollars. Both the False Claims Act and TMFCA provide financial incentives to qui tam whistleblowers who report fraud by giving them portion of the recovery. Specifically, whistleblowers can recover up to 30% of a claim under the False Claims Act and up to 33% of a claim under the TMFCA. Approximately $200 million were paid to whistleblowers last year.

Qui tam statutes provide the amount of recovery. Qui tam (pronounced “kwee tam”) is short for a Latin phrase that roughly translates that a person sues for the king as well as him or herself. A whistleblower working with a qualified qui tam attorney can sue for three times the government’s damage plus civil penalties ($5,500 to $11,000 per claim).

Commonly Seen Qui Tam Whistleblower Cases

Corporations defrauding the government occur more often than many people realize. Qui tam whistleblowers have reported fraud in a number of large companies including Lockheed Martin, University of Phoenix, OfficeMax, and many more. While government fraud occurs in a wide variety of areas, most qui tam cases involve the health care industry.

Some commonly seen methods of fraud within the health care industry include double-billing customers or ghost-billing customers that may not even exist. Other methods can include companies billing Medicare, Medicaid, or TennCare for supplies that are never used. Companies may also attempt to substitute cheaper equipment or even separate individual procedures that result in higher bills. Tennessee hospitals, laboratories, nursing homes, surgeons, and chiropractors have all been found committing health care fraud.

Unfortunately, many Tennesseans do not understand the full effects of health care fraud. Not only do Tennesseans suffer higher taxes because of health care fraud, some individuals have suffered physically as a result. Certain qui tam cases have shown doctors diluting chemotherapy medications. Other qui tam cases have revealed veterans being mistreated in veterans’ homes attempting to cut costs while still charging the same amount.

Qui Tam Whistleblowers Must Meet Certain Conditions

Under both the False Claims Act and TMFCA, a whistleblower (called a relator) must meet certain conditions to receive qui tam moneys. Some of those conditions include:

  • The whistleblower must be an employee or professionally involved with the guilty party.
  • The whistleblower must file the complaint before another whistleblower files.
  • The whistleblower must not have initiated the misuse for the purpose of filing a qui tam lawsuit.
Preventing Retaliation

The whistleblower or relator’s identity will initially be confidential as a means of preventing retaliation. However, if or when a whistleblower’s identity is revealed, federal and state employment laws prohibit retaliation against the relator. If retaliation does indeed occur during the lawsuit, the whistleblower can be awarded damages that include reinstatement, twice the amount of pay withheld from the employee, as well as attorney’s fees.

A qualified Tennessee qui tam attorney can ensure that you receive all of the protections that you are provided under the law. The Higgins Firm’s team of experienced Tennessee qui tam attorneys can help you make the best of your claim.