QUI TAM is an ancient concept, as the Latin indicates, with its roots in Old England. Its first appearance in this country was in the form of legislation passed by President Lincoln during the Civil War to prevent profiteering.
It allows for a private citizen with knowledge of a violation of the federal False Claims Act to bring an action on behalf of the Government for a variety of practices. In the Health Care field, these include:
- Billing for services not performed or required
- Falsifying the nature of the services provided
- Falsifying the nature of the services billed
The federal False Claims Act does not limit itself to health care, although those types of cases make up a large percentage of QUI TAM actions pending. Other types of cases include:
- Defense contractor fraud
- Insurance company fraud
- University and college fraud involving government funding
- Fraud involving other government contractors or entities receiving government funding
The plaintiff need not be a present or former employee, just a person with some knowledge of the violation. Provisions are in place which will protect the employee from adverse action taken in retaliation for "blowing the whistle" on the employer''s illegal activity in the form of reinstatement and damages, including double the amount of lost pay.
The QUI TAM plaintiff may receive between 18 and 30% of any recovery. Congress provided for a large incentive given the huges potential losses from the variety of fraud which is committed each year.
Before a suit is instituted, the QUI TAM plaintiff must notify the Justice Department of the violation and the plaintiff''s intent to prosecute. The Justice Department may choose to dip into its limited resources and prosecute themselves. If this occurs, the plaintiff may still recover a portion of any award. If not, the percentage the plaintiff may be awarded is substantially higher.
If you have any questions, please e-mail Martin Levin or call Mike Papantonio at 1-888-435-7001.