What is the qui tam process and how does it affect me?

I worked for several years at a retirement home, where I witnessed multiple acts of Medicare fraud. What is the qui tam process and how does it affect me?

Answers (1)

There are many types of Medicare fraud, including billing for services not performed, performing unnecessary procedures, performing unnecessary testing, etc. Under the False Claims Act (31 U.S.C. Sections 3729-33) or “Qui Tam statute,” private individuals with knowledge of past or present fraud on the government may sue on behalf of the government to recover civil penalties and triple damages. This person is formally known as the “Relator.” If the suit is successful, the dishonest conduct is stopped, and the relator may receive a substantial share of the government’s ultimate recover, as much as 30% of the total.

Consult an attorney who can help you understand whether fraud exists and can be proved. The attorney can help to analyze federal rules, regulations and laws, consider the likelihood of proving a claim with the curren evidence, and help gauge the government’s interest in the lawsuit. In short, an attorney can help to serve as a navigator through the very detailed and possible complicated process.

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