Standing Up to Fraud Against the Government
Every year, fraud against the United States Government costs taxpayers tens of billions of dollars. The False Claims Act (FCA) — one of the most powerful anti-fraud statutes in American law — empowers private citizens who have inside knowledge of that fraud to file a lawsuit on the government's behalf. These lawsuits are known as qui tam actions, and the individuals who file them are called relators.
In exchange for their courage and their evidence, relators are entitled to receive between 15% and 30% of whatever the government recovers — potentially millions of dollars in cases involving large-scale fraud.
RNC Legal represents relators throughout the qui tam process: evaluating the strength of the case, filing the complaint under seal, working with the Department of Justice during the government's investigation period, and litigating to judgment if the government declines to intervene.
The False Claims Act — What You Need to Know
The False Claims Act, 31 U.S.C. §§ 3729–3733, imposes civil liability on any person or entity that knowingly submits false or fraudulent claims for payment to the United States Government, or that knowingly causes false claims to be submitted. Liability can include treble damages (three times the government's actual losses) plus civil penalties for each false claim submitted.
Key Features of the False Claims Act
Qui Tam Provision: Private citizens with inside knowledge can file on the government's behalf and share in the recovery.
Relator's Share: Between 15–25% if the government intervenes; 25–30% if the relator proceeds without government intervention.
Retaliation Protection: Federal law prohibits employers from retaliating against employees who report FCA violations. Reinstatement, back pay, and additional damages are available to retaliation victims.
Filed Under Seal: The complaint is initially filed under seal and kept confidential while the government investigates — protecting the relator during the most sensitive phase of the case.
Types of Fraud We Handle
Healthcare & Medicare/Medicaid Fraud
Healthcare fraud is the single largest category of False Claims Act cases in the United States. If you are a healthcare professional, administrator, billing specialist, or other insider who has witnessed fraud in the healthcare industry, you may have a powerful qui tam claim.
- Billing for services not rendered
- Upcoding — billing for more expensive procedures than actually performed
- Unbundling — billing separately for procedures that should be billed together
- Kickbacks and illegal referral arrangements (Anti-Kickback Statute)
- Off-label drug or device marketing
- Medically unnecessary procedures or hospitalizations
- Home health and hospice fraud
- Laboratory and diagnostic testing fraud
Government Contract Fraud
Defense contractors, construction companies, technology vendors, and other government suppliers sometimes submit false invoices, substitute inferior materials, or misrepresent their qualifications in order to obtain or retain government contracts. If you have insider knowledge of such conduct, you may be positioned to file a False Claims Act case.
- Billing for unperformed work or inflated hours
- Substituting lower-grade materials than specifications required
- Misrepresenting small business, minority-owned, or veteran-owned status
- Defective product submissions to the military or government agencies
- False cost or pricing data under the Truth in Negotiations Act
- Research grant fraud and false certification to federal agencies
Other Federal Program Fraud
- Student loan and financial aid fraud
- SBA loan fraud (including PPP/COVID relief fraud)
- Tax fraud and customs fraud
- Housing and HUD fraud
- FEMA and disaster relief fraud
Who Can File a Qui Tam Lawsuit?
Any person with inside, non-public knowledge of fraud against the government may be eligible to serve as a qui tam relator. The most common relators are:
- Current or former employees of the company committing fraud
- Healthcare professionals aware of billing or coding fraud at their employer
- Contractors or subcontractors with knowledge of a prime contractor's fraud
- Competitors who discovered the fraud through legitimate business dealings
- Accountants, auditors, or compliance officers with documentary evidence
Important limitation: the "first-to-file" rule generally bars a relator from proceeding if another person has already filed a qui tam complaint based on the same underlying facts. This makes it especially important to consult with experienced counsel quickly once you have identified potential fraud.
Whistleblower Retaliation — Your Legal Protections
Federal law provides robust protections for employees who report or assist in FCA investigations. Under 31 U.S.C. § 3730(h), an employer may not discharge, demote, harass, threaten, or otherwise retaliate against an employee for engaging in protected whistleblower activity. If you have experienced retaliation, you are entitled to:
- Reinstatement to your former position
- Two times the amount of back pay, with interest
- Compensation for any special damages sustained as a result of the discrimination
- Attorney's fees and costs
Many whistleblowers hesitate to come forward out of fear of losing their job. The law was designed to address exactly that concern — and RNC Legal will hold any retaliating employer accountable to the fullest extent of the law.
How a Qui Tam Case Works
- Confidential Consultation — You meet with RNC Legal to discuss what you know. Everything you share is protected by attorney-client privilege. Critically, prospective whistleblowers must be careful not to disseminate or publicly disclose what they have discovered before filing — sharing the information with colleagues, the press, or others outside the attorney-client relationship can jeopardize the confidentiality of the complaint and, in some circumstances, your eligibility for a relator's share of the recovery.
- Case Evaluation — We evaluate the strength of the evidence, identify the legal theories, and assess the potential recovery.
- Filing Under Seal — We prepare and file the qui tam complaint with the federal court under seal, along with a detailed disclosure statement for the Department of Justice.
- Government Investigation — The DOJ and relevant agencies investigate. The case remains sealed (confidential) while the government decides whether to intervene. This period typically lasts six months to several years.
- Intervention Decision — If the government intervenes, it takes over primary litigation. If it declines, we can proceed on your behalf independently.
- Recovery & Relator's Share — Upon successful resolution, you receive your relator's share of the government's recovery.
