Qui tam whistleblower cases are a special subset of whistleblower cases. These lawsuits at both the federal and Tennessee-level are special for two reasons: 1) qui tam lawsuits only involve the first employee to appropriately file a report of his or her employer’s defrauding of the government and 2) the significant monetary awards the government offers for filing fraud.
Qui Tam under U.S. and Tennessee False Claims Act
The qui tam statutes, also known as the “False Claims Act,” were established during the U.S. Civil War to reduce the rampant corporate fraud against the Union government. Qui tam statutes continue today and are vital to the Department of Justice’s job of uncovering corporate fraud against the government. Tennessee also recovers state taxpayer money every year through its similar Tennessee False Claims Act and Tennessee Medicaid False Claims Act.
Qui Tam Whistleblower Awards
Recoveries from qui tam cases are used to restore losses to the public, including reimbursing government agencies and regulators who investigate fraud against taxpayers. A significant portion of the moneys recovered go to the qui tam whistleblower.
The qui tam whistleblower working with a qualified lawyer can sue for three times the government’s damages plus civil penalties ($5,500 to $11,000 per claim). In federal cases, the whistleblower, referred to as the “relator,” is entitled to 15-30% of the final recovery. In the 2006 fiscal year, federal qui tam relators were awarded over $190 million. Tennessee False Claims Act rewards Tennessee relators with an even higher percentage of 25%-33% of the action or settlement.
But to file a qui tam action against an employer who is defrauding the government, you must be the first to file. There are no class actions and no claim if another files first. There is only one: the first to file.
If you think you might have a False Claims Act case, contact the Higgins Firm immediately to take action. Higgins Firm workplace attorneys can make sure a relator’s identity remains confidential during the filing process and can protect the client from retaliation.
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Ways Businesses Defraud the Government
Qui tam cases revealing fraud or misuse of government funds have involved almost every type of industry. Fraud against the government is most common in healthcare industries (about half of all federal qui tam cases) and in military contracts (about 30%). Exxon Mobile, Morgan Stanley, OfficeMax, Hewlett-Packard and many other well-known corporations have had qui tam cases filed against them for underpayment of royalties on government leased lands, subsidies abuse, research programs, customs and other withheld moneys and/or false billings to the government.
Medicare Fraud – The Most Common Fraud to the Government
Medicare fraud remains the most common type of qui tam cases in the U.S. and Tennessee. Many of the same schemes behind Medicare fraud are used in other cases of government fraud, including
 Fraudulent billing for supplies or equipment not used
Fraudulent employee health care or saving plans
Charging for unnecessary/inappropriate services
Billing for employees or work hours that do not exist
Medicare and other insurance fraud can also include
Waiving co-payments
Upcoding (charging for premium treatment or prescription, such as for a name brand drug when a generic was used)
Unbundling (fraudulent billing for individual services that should be part of single billing package)
These forms of insurance fraud have been found in all areas of health care, including Tennessee hospitals, EMS services, psychiatric wards, pharmacies and nursing homes.
Taking Qui Tam Action with a Trusted Tennessee Attorney
Both the federal and Tennessee laws governing qui tam actions protect the relator from workplace harassment and retaliation. Working with an employment lawyer can help protect your identity during the filing process and offer additional protections. If retaliation should occur, you may be awarded additional damages, including the pay you would have earned if working (back pay) and reinstatement.
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