How Can I File A Whistleblower Lawsuit Under the False Claims Act?

Under the False Claims Act (FCA) you are not permitted to file a lawsuit without the use of a whistleblower law firm. Just like you wouldn’t try to do your own surgery, filing your own lawsuit is generally a foolish idea, and is in fact prohibited under the FCA.

The False Claims Act generally involves the reporting of illegal activities conducted by a facility or particular person, which causes the government to suffer a loss of funds. There are many types of whistleblower cases that can be reported and filed since fraud against the government, and federally funded programs occur in various industries, such as Medicare Fraud, Medicaid Fraud, Defense Contractor Fraud, Contract Fraud and Education Fraud. Almost any type of economic fraud against the government can be remedied with the False Claims Act. A whistleblower case, which can also be referred to as a Qui Tam lawsuit, is initiated after a person with information exposing the fraudulent activities comes forward with appropriate evidence in the correct manner by filing the lawsuit under seal with a disclosure statement with the use of qui tam counsel.

Each year, whistleblowers help the United States recover billions of dollars lost to fraud against the government. In fiscal year 2024 alone, the Department of Justice (DOJ) reported over $2.7 billion in recoveries under the False Claims Act (FCA), most of which originated from whistleblower lawsuits. These courageous individuals not only protect taxpayer dollars but also play a vital role in holding corporations accountable. If you’ve uncovered evidence of government fraud, understanding how to properly file a False Claims Act case is the first step toward justice.

The False Claims Act is a federal law that allows private citizens to help the government combat fraud. Originally enacted during the Civil War to address defense contractor fraud, the FCA remains one of the most powerful anti-fraud tools in existence. Under the FCA, any person or company that knowingly submits false or fraudulent claims for payment to the federal government can be held liable for treble damages (three times the government’s losses) plus civil penalties.

Key terms to know include:

• Qui Tam: A Latin phrase meaning “who sues on behalf of the king as well as himself.” In practice, it means a private person (the whistleblower) can bring a lawsuit on behalf of the government.
• Relator: The legal term for the whistleblower who files the FCA case.
• Materiality: Refers to whether the false statement or claim had a significant impact on the government’s decision to pay or approve funds.

What Information Qualifies for Whistleblower Cases?

Individuals who witness illegal activities at their workplace are not always sure whether they may qualify as a whistleblower and if the evidence they may be able to collect would be eligible for the filing of a case under the various statutes such as the False Claims Act (FCA). Understanding the qualifying criteria for these cases is important to help individuals, including employees, know if they can come forward, how they can come forward, and what procedures need to be followed.

Generally, a whistleblower is a person who is an insider who is in the position to blow the whistle using their detailed information regarding the illegal conduct at the company. People from all different positions have filed whistleblower cases that succeeded, the core information is if the business interfaces with the government, and how it is defrauding the government. The bulk of whistleblowers under the FCA are people in the medical field, like Doctors, Nurses, CNAs, Hospital Administrators and other Health Care Workers. But almost anyone who has inside information about fraud against the government can serve as a whistleblower, including, bookkeepers, executives, sales consultants, tax consultants, assistants, receptionists, and office or inside workers. The issues of attorney-client privilege still attach so professionals like lawyers and accountants may be precluded from blowing the whistle in certain circumstances.

For a lawsuit to qualify as a whistleblower case under the FCA, the first important fact to establish is that these cases must be related to a party committing fraud that is adversely affecting the government. There are other types of whistleblower statutes for other types of frauds, but the most successful ones in recent years have been the False Claims Act which requires the use of a False Claims Act Lawyer, the SEC Whistleblower Provisions, the CFTC Whistleblower Provisions and various state qui tams like Illinois False Claims Act and California False Claims Act, which also provide for relief against frauds against private insurance companies.

False claims can arise in nearly every industry that receives federal funds. Some of the most common examples include:

• Healthcare Fraud: Billing Medicare or Medicaid for services not rendered, upcoding procedures to increase reimbursement, or paying kickbacks for patient referrals. Example: A hospital chain falsely billing for unnecessary tests or surgeries.
• Defense Contractor Fraud: Overcharging for materials, substituting substandard parts, or inflating labor hours on military projects. Example: A defense contractor submitting invoices for non-existent employees.
• Procurement Fraud: Misrepresenting compliance with contract terms or failing to meet federal quality standards. Example: A construction firm cutting corners on federally funded infrastructure work.

Examples of a False Claims Act fact pattern is as follows. A hospital or a nursing home who bills Medicare or Medicaid for an extra night for its patients when they have already been discharged, a Defense Contractor who allows faulty parts to go to the government and certifies they are compliant and knows they are not, and a Pharmaceutical Sales Representative who knowingly promotes a drug for off-label purposes which can be its own topic about how the government is harmed.

Nearly anyone with original, non-public information about fraud against the government can file a False Claims Act lawsuit. A few key principles guide eligibility:

• Original Information: The information must not be publicly disclosed or already known to the government.
• First-to-File Rule: Only the first whistleblower to file a valid case on a specific fraud scheme can proceed.
• Filing Under Seal: The lawsuit must be filed confidentially “under seal,” meaning it remains secret while the DOJ investigates.

The False Claims Act protects whistleblowers from retaliation such as termination, demotion, harassment, or discrimination. If retaliation occurs, the whistleblower may be entitled to reinstatement, double back pay, and compensation for damages. In addition to these protections, the FCA offers significant financial rewards. If the government intervenes and recovers funds, whistleblowers are typically entitled to 15% to 25% of the recovery. If the whistleblower continues the case independently (without government intervention), the share can increase to 25% to 30%. These provisions recognize the personal and professional risks whistleblowers take and encourage insiders to come forward.

Recent court decisions have refined how the FCA is applied. In United States ex rel. Schutte v. SuperValu Inc. (2023), the Supreme Court clarified that a defendant’s subjective knowledge of falsity matters, even if their interpretation of regulations was objectively reasonable. This ruling strengthens the FCA by ensuring companies cannot evade liability through clever reinterpretations of ambiguous rules. The DOJ has also ramped up enforcement efforts in sectors like healthcare technology, cybersecurity compliance, and COVID-19 relief programs, areas ripe for FCA exposure as federal funding expands.

Fraud occurs in the healthcare industry, as well as many other industries. If you think you have information regarding your employer defrauding Medicare, Medicaid or committing other types of fraud, you should speak with a whistleblower lawyer. At Brown, LLC, we offers free, confidential consultations nationwide, and we’re only paid if they win your qui tam lawsuit.

The False Claims Act empowers ordinary citizens to play an extraordinary role in protecting public funds. Understanding how to properly file an FCA lawsuit ensures that both the government and the whistleblower can hold fraudulent actors accountable. Whether you work in healthcare, defense, or any industry that relies on government contracts, recognizing the signs of fraud can make all the difference.