What is a Qui Tam Relator? An Insight into Whistleblowing and Protecting Government Interests

The term “Qui Tam Relator” might sound arcane, but its implications in safeguarding government programs are vast. A qui tam “relator” is the legal term for the private individual or entity who serves as a whistleblower, acting as the government’s informant in cases where the government might have been defrauded. But what exactly is a qui tam relator, and how do they navigate the legal landscape? In this blog post, we’ll explore the world of qui tam relators, their origins, rewards, legal protections, challenges, and some real-life examples of their impact.

Key Takeaways

• Qui tam relators are private citizens or entities who report fraud against the government and are legally protected by the False Claims Act.
• Becoming a qui tam relator involves having substantial evidence of fraud, enlisting legal assistance, understanding applicable laws, and potentially litigating if the government does not intervene.
• Qui tam relator rewards & incentives vary based on quality of information provided as well as outcome of case. Whistleblowers have additional protections from employer retaliation under various whistleblower protection laws.

Understanding Qui Tam Relators

An individual, business, or partnership who initiates whistleblower actions alleging fraud against the state or federal government are known as qui tam relators. Their primary role is to unearth and expose fraudulent activities carried out by organizations. Qui tam claims often allege fraud involving Medicare, Medicaid, defense contractors, or public procurement. All of these cases involve defrauding the government.

The False Claims Act provides legal protection to qui tam relators, granting private citizens the right to sue any individual or organization that has attempted to defraud the government through false claims.

The Origins of Qui Tam

“Qui tam” hails from Latin, specifically the 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.” This ancient concept allows private individuals or entities to bring forth lawsuits on the government’s behalf, aiming to expose and penalize fraudulent actions against it.

Differences Between Qui Tam Relators and Whistleblowers

While the terms “qui tam relator” and “whistleblower” are often used interchangeably, there are important distinctions to consider. The primary distinction lies in the legal environment in which they are utilized. Qui tam relator is an individual or entity who brings a lawsuit on behalf of the government under the whistleblower provisions of the False Claims Act. On the other hand, “whistleblower” is a more comprehensive term that refers to individuals who report any form of misconduct or unlawful activity, not restricted to False Claims Act cases.

These differences extend to their roles and protections, with qui tam relators being eligible for rewards and incentives under the False Claims Act, while whistleblowers may be eligible for additional safeguards under other whistleblower protection laws.

Becoming a Qui Tam Relator: Eligibility and Process

In pursuing a qui tam claim, one must possess substantial evidence of fraud, which could include:

• emails
• financial records
• internal memos
• occasionally recorded verbal evidence

As qui tam relators navigate the legal process, they often enlist the help of experienced attorneys who can guide them through the complexities of the False Claims Act and ensure that all relevant paperwork is filed.

The government plays a significant role in qui tam cases, assessing the allegations and deciding whether to intervene in the whistleblower’s case. Depending on the government’s intervention decision, the relator’s role and potential rewards may differ significantly.

Who Can Be a Qui Tam Relator?

Individuals who are employed, contracted, or possess intimate knowledge of the fraud may qualify as a Qui Tam Relator. However, to be qualified, they must:

• Have access to information not available to the public.
• Have direct and independent knowledge of the fraud.
• Have adequate knowledge of the fraud to back up a False Claims Act complaint.

The role of qui tam relators is pivotal in unmasking government fraud, with their insider knowledge often being a deciding factor in the success of a qui tam case.

Filing a Qui Tam Lawsuit

The process of filing a qui tam lawsuit involves several steps, starting with:

1. Preparing the case and gathering evidence.
2. Filing a civil complaint under seal with the appropriate court.
3. Providing a copy of the complaint, documentation, and evidence to the Attorney General and the United States Attorney.
4. The complaint remains under seal for at least 60 days, during which the government investigates the allegations.

Depending on whether the government intervenes or not, the relator may proceed with the lawsuit on behalf of the government or independently. The case is unsealed and served upon the defendant, beginning the litigation process, which may result in a settlement or trial.

Qui Tam Relator Rewards and Incentives

Financial rewards and incentives may be available to qui tam relators who manage to successfully expose government fraud. These rewards are often calculated as a percentage of the total amount collected by the government, with percentages typically ranging from 15% to 30%. The size of the reward depends on various factors, such as the degree of the relator’s contribution and whether the government intervenes in the case.

Qui tam relators have been rewarded with a cumulative amount of over $8 billion since the 1986 amendment of the False Claims Act.

Legal Protections for Qui Tam Relators

The qui tam provisions of the False Claims Act protect qui tam relators by prohibiting any retaliation for filing a qui tam action or attempting to halt violations of the Act. This legal protection extends to both company employees and independent contractors and agents.

The False Claims Act includes specific anti-retaliation provisions that protect qui tam relators from suffering any adverse consequences as a result of their actions. For example, if an employer retaliates against a whistleblower for filing a qui tam action or reporting violations of the False Claims Act, the employer is required to provide relief to the whistleblower, such as reinstatement to their position, double the amount of owed back pay, and compensation for any damages.

Engaging a Qui Tam Lawyer

Undertaking a qui tam relator case without legal representation is akin to navigating treacherous waters without a compass. Qui tam cases, rooted in the False Claims Act, are complex, and their successful prosecution can require deep knowledge of the law, evidentiary rules, and procedural nuances. Here are compelling reasons why you should consider retaining a lawyer if you’re contemplating initiating a qui tam case:

1. Complexity of the Law: The False Claims Act is replete with legal intricacies, from the specifics of what constitutes a false claim to the requirements for a relator to be eligible for a reward. A seasoned attorney can dissect these complexities, ensuring your case is built on a solid legal foundation.
2. Guidance on Merits: Not all perceived wrongs qualify for qui tam actions. An experienced attorney can evaluate the merits of your case, ensuring it meets the necessary criteria under the False Claims Act.
3. Securing Maximum Rewards: While the False Claims Act offers financial rewards to relators, the exact percentage can vary based on several factors, including whether the government intervenes. A lawyer can advocate for you, aiming to secure the highest possible portion of the recovered funds.
4. Protecting Your Rights: The False Claims Act offers protection against retaliation for whistleblowers. Should you face adverse actions from your employer, having an attorney becomes crucial to defend your rights and seek remedies.
5. Negotiating Settlements: Many qui tam cases result in settlements rather than full trials. Experienced qui tam lawyers have the negotiation skills needed to broker a favorable resolution for both the government and the relator.
6. Handling Procedural Nuances: Qui tam actions have specific procedural requirements, such as the need to provide the government with a detailed disclosure of evidence before filing. Missing these steps could spell the end of your lawsuit, emphasizing the need for knowledgeable legal counsel.

Real-Life Examples of Qui Tam Cases

In recent years, qui tam cases involving healthcare fraud, defense contractor fraud, and government contract fraud have garnered considerable attention. These cases highlight the vital role qui tam relators play in uncovering and stopping fraud against the government, ultimately protecting taxpayers and ensuring that public funds are used responsibly.

Healthcare Fraud Cases

Healthcare fraud cases comprise a significant portion of qui tam litigation, with instances involving Medicaid and Medicare fraudulent billing, overcharging the government, and false claims related to healthcare services. For example, one hospital was accused of submitting false claims to Medicare for services not medically necessary and a pharmaceutical company was accused of paying kickbacks to doctors in exchange for prescribing their drugs.

Government Contract Fraud Cases

Qui tam cases involving government contract fraud include defense contractor fraud, military procurement fraud, and other instances of fraud related to government contracts.

Summary

In conclusion, qui tam relators play a crucial role in holding entities accountable for fraudulent actions against the government and ensuring the integrity of government programs and contracts. Qui tam relators are supported by legal protections and financial rewards, providing incentives for them to come forward and report fraud.

When contemplating the initiation of a qui tam lawsuit, it is advisable for potential qui tam relators to consult with an experienced qui tam attorney. This ensures a thorough assessment of the case’s validity and proper strategizing for the proceedings ahead.