The qui tam provision of the False Claims Act allows private individuals to bring civil cases against entities who have submitted false claims to the government. The whistleblower who brings the case to the government’s attention (and their lawyers) can win a substantial portion (15-30%) of the final settlement or judgment. This provision has been used extensively in Medicaid and Medicare fraud cases.

The qui tam provision is a great incentive for people to turn in their bosses for committing fraud. However, it only helps stop a small amount of fraud. The settlement amounts seem large, but the amount of fraud that goes unpunished is at least ten times larger.

In 2002 the Federal Government used various provisions of the False Claims Act to recover almost $1 billion in healthcare settlements and judgments. Some of the big cases in 2002 were:

TAP Pharmaceuticals, (a joint venture between Abbott Laboratories and Takeda Chemical Company) $568 million PacifiCare Health Systems $87.3 million General American Life Insurance Company $76 million State of California and the County of Los Angeles $73.3 million Lifemark Hospitals of Florida (a subsidiary of Tenet Healthcare Corporation) $29 million 139 hospitals owned and operated by Tenet $17 million

This DOJ website summarizes some of the bigger cases last year: 2003 DOJ False Claims Act Press Release
2002 DOJ False Claims Act Press Release

Additional Qui Tam statistics can be found here: Qui Tam stats