False Claims Act / Qui Tam

The False Claims Act is the federal government's primary civil tool for pursuing fraud against public programs, covering false billings, false certifications of compliance, and the retention of overpayments. It carries treble damages and per-claim penalties, and it lets private whistleblowers, called relators, sue on the government's behalf and share in any recovery. We advise companies on FCA exposure and represent them in matters before the Department of Justice and US Attorneys' Offices.

A qui tam suit is a False Claims Act case filed by a private person, the relator, in the name of the United States. The complaint is filed in camera with a written disclosure of the relator's evidence served on the government alone, and it stays under seal for at least sixty days, routinely extended for a year or more, while the Department investigates and decides whether to intervene, decline, or move to dismiss. The defendant is not served until the court lifts the seal, so a company may be investigated for a year without seeing a caption. The first relator to file blocks later relators on the same facts, and the relator's share of any recovery runs from fifteen to thirty percent depending on whether the government takes the case.

We begin with an early assessment of the conduct, the claims at issue, and the realistic damages and penalty exposure, then build a strategy around the elements the government has to prove: falsity, knowledge, and materiality. That includes responding to civil investigative demands and subpoenas, engaging with DOJ on intervention and resolution, and preserving every defense for trial if the matter does not resolve. The same partner answers for the matter from the first subpoena to the release.

Start with the government's actual loss, treble it, then add a penalty for every false claim, a figure indexed to inflation each year and now well into five figures per claim. Because the penalty counts claims rather than schemes, a modest coding error repeated across thousands of invoices produces a headline number far above the loss, and the count is often proved by sampling. A losing defendant also pays the relator's attorney's fees, and the inspector general's exclusion authority and the procurement debarment rules sit outside the judgment altogether. Most matters settle at a negotiated multiple of single damages, which is why the single-damages model is the first document we build.

It can, and the statutes sit side by side. The conduct that supports a civil false claim is also charged under Title 18 as a false claim, a false statement or health care fraud. The civil and criminal Assistant United States Attorneys coordinate under the Department's parallel-proceedings policy. Testimony on a civil investigative demand is sworn and usable in the criminal case, a corporation cannot invoke the Fifth Amendment, and an individual who does so in the civil case may face an adverse inference there. We run the civil defense with the criminal exposure mapped from the start, and we advise early on separate counsel for any employee whose interests may diverge.

At the hotline report, not the subpoena. An identified Medicare or Medicaid overpayment must be reported and returned within sixty days or it becomes a reverse false claim, so the internal review that decides whether an overpayment exists has to start the week the question is raised, and it has to run under privilege. A civil investigative demand, an inspector general's subpoena, or the resignation of someone who handled billing or compliance are later signals, and each narrows the options. One more reason to call early: an employee who raised the issue internally is protected by the Act's retaliation provision, which carries reinstatement and double back pay, so the handling of that person is itself a claim waiting to happen.