Qui Tam
The term “Qui Tam” originated in medieval England and its meaning comes from the Latin, “who sues on behalf of the King as well as for himself.” It became a part of United States jurisprudence during the Civil War when President Lincoln moved to stanch the epidemic of defective military supplies being sold to the Union. For approximately 140 years after the adoption of the False Claim Act (originally called the Lincoln Law) and its Qui Tam provisions, the U.S. Department of Defense contributed the lion’s share of cases and rewards to whistleblowers, much of which was attributable to the nation’s military build-up in the 1980’s.
In 1986, when the law was amended to increase rewards for whistleblowers and provide additional protections for those who stepped forward to report fraud, healthcare began its ascent towards becoming the predominate industry giving rise to Qui Tam lawsuits alleging violations of the False Claim Act. By the 1990’s, healthcare supplanted defense as the predominant government expenditure giving rise to Qui Tam litigation.
By 2020, it is estimated by the trade journal Health Affairs that half of the nation’s annual healthcare costs — an astounding $2.28 trillion — will be borne by the federal government. There is little doubt that in the foreseeable future healthcare fraud will continue to be the industry in which the greatest number of Qui Tam actions are filed as the federal government spends more and more on Medicare and Medicaid. With trillions of dollars being spent, the healthcare sector will continue to be a key target for those who would seek to defraud the federal government.
The Law Office of Arthur W. Leach has extensive experience advising clients on the False Claims Act (FCA) and defending FCA lawsuits and related civil and criminal investigations. Our lawyers have assisted Fortune 500 and nonprofit companies in many significant FCA matters. Our experience working with the U.S. Department of Justice can assist us in protecting our clients interests and their reputations. We believe that the best way to win or favorably settle a qui tam case is to prepare to try it. That means more than just motion practice. We deploy firm-wide resources including the insight from our Corporate Compliance, Investigations and Defense, Corporate Governance, and Labor and Employment practice groups. From pretrial through trial and appeal, our litigation services span the entire life of a case, including counseling on government intervention and associated publicity issues.
The FCA reaches all companies doing business with the government, such as government contractors, grantees, and other recipients of federal funds through programs like Medicare and Medicaid. FCA suits are brought in every industry, ranging from government procurement and health care to the communications and financial services industries. We routinely conduct internal investigations, respond to government investigations, defend lawsuits filed under the FCA, defend retaliation lawsuits brought by alleged whistleblowers and seek to avert debarment and exclusion proceedings. We have proven experience in handling the most complex and high-stakes FCA matters, and our team includes lawyers with experience working at the U.S. Department of Justice on FCA matters. This government experience provides the Law Office of Arthur W. Leach clients with invaluable insights into government strategy and decision-making in FCA litigation and lays the groundwork for effective negotiations with government officials.
False Claims Act cases are among the most significant risks faced by health care and other entities today. More aggressive and better funded regulators, an increasingly sophisticated and specialized qui tam bar, the rise of the internal whistleblower and the expansion of statutory liability have resulted in staggering judgments and settlements against providers and pharmaceutical and device manufacturers.
The Law Office of Arthur W. Leach’s proactive approach to defending these matters targets the key steps in such investigations to maximize a successful result as early as possible. Our knowledge of the broad array of statutory, regulatory and agency requirements, combined with our deep experience in conducting internal investigations within the health care industry, allows us to assist the client in conducting a cost effective assessment of the potential risk involved early in the proceeding.
Our experience includes winning numerous dismissals and defense verdicts in qui tam cases for clients faced with whistle-blower allegations and claims seeking damages and steep civil penalties. Sophisticated and inherently complex, qui tam litigation commonly involves technical issues in science and medicine and an ever-developing body of Federal whistle-blower laws. In these high-stakes and often high-visibility cases under the civil False Claims Act (FCA), the Law Office of Arthur W. Leach’s highly experienced trial lawyers defend clients with straight talk assertiveness.
We represent participants in all aspects of health care and life sciences:
- health plans and managed care organizations
- hospitals and health care systems
- medical device and technology manufacturers
- pharmaceutical companies
- lenders, investors and underwriters involved in health industry transactions.
The Law Office of Arthur W. Leach combines the knowledge and experience of its health industry, intellectual property, food and drug law, public law and policy, corporate and tax practices to assist pharmaceutical industry clients in navigating the complex array of policies and regulations to which their industry is subjected.
Our award-winning team has industry-leading experience representing hospitals and health care systems on a wide range of matters involving regulatory compliance, Medicare and Medicaid reimbursement, legislative and policy advocacy, HIPAA, fraud and abuse, transactions, financial restructuring, tax and antitrust.
Obtaining recoveries for whistleblowers and upholding the public trust
The Law Office of Arthur W. Leach also represents whistleblowers in a wide range of False Claims Act cases, including medicare and heaalthcare fraud, defense contractor fraud, securities and financial fraud, and many other false claims. We have the resources, experience, and skill to appropriately investigate even the largest and most complex matters and take them all the way through trial.
Who can be a whistleblower?
The “qui tam” provision of the False Claims Act allows a person or people to act as whistleblowers and sue the wrongdoer on behalf of the U.S. government. In such cases, the whistleblower is referred to as a “relator.” These cases are known as qui tam lawsuits.
A successful whistleblower is entitled to a percentage (ranging from 15 to 30 percent) of the total amount of monies the government recovers as a result of the lawsuit.Any person or entity that has evidence of a fraud occurring against the government may act as a whistleblower under the False Claims Act.
Other whistleblower laws
Under the financial reform legislation enacted in 2010, known as the Dodd-Frank Wall Street Reform and Consumer Protection Act, whistleblowers who provide the Securities and Exchange Commission or the Commodity Futures Trading Commission with information about a violation of federal securities laws may be entitled to a reward if the government acts on that information. The recovery in this type of whistleblower case can be from 10 to 30 percent of the amount the government collects.
The majority of states now also have qui tam or similar statutes, and so claims involving losses to states may also be actionable.
The Internal Revenue Service has its own separate whistleblower provision as well for tax fraud.
In Sum, The Law Office of Arthur W. Leach can defend the largest qui tam or prosecute them based on our unique experience as both prosecutors and defenders of such cases. The firm handles all qui tam prosecution cases on a contingency fee basis, meaning that the firm earns a fee only if it is successful for the whistleblower. The firm also represents individuals in white-collar civil and criminal cases. Many whistleblowers with inside information may have civil and potentially criminal exposure, and decisions will need to be made about the risks of pursuing a qui tam case. The Law Office of Arthur W. Leach has expertise in both qui tam and white collar matters. Most qui tam law firms do not have this dual expertise.