Reasons the DOJ May Decide to Intervene in a False Claims Act Case

Whistleblowers are encouraged to file False Claims Act cases to disclose fraud involving payments by the government. The whistleblower claims are called qui tam actions. The qui tam actions often involve Medicare and Medicaid fraud. They can involve the Department of Defense or any agency that makes payments in good faith for services or products.

There are specific criteria that must be met to qualify as a whistleblower. For example, the disclosure can’t be about something that is public record or something the government already knows about. Whistleblowers are entitled to a percentage of any recovery. The amount of the percentage varies depending on whether the US Department of Justice decides to intervene or not to intervene.

If the DOJ intervenes, then the DOJ acts as the prosecutor in the case. The DOJ files the formal complaint against the defendant, conducts an investigation, and conducts discovery. If the DOJ declines to intervene, then the whistleblower, with the help of legal counsel, can file his/her own claim against the wrongdoers. The amount of the whistleblower award/percentage is generally higher when the DOJ does not intervene. The odds of success, however, are generally higher if the DOJ does intervene.

The DOJ will consider the following factors in deciding whether to intervene

  • The amount of the false payments. Very small payments usually aren’t worth intervening unless the DOJ wants to send a message to other defendants.
  • The merits of the claim. The DOJ will review the disclosures by the whistleblower in determining if they have merit and how the claims can be proved.
  • The ability to negotiate a settlement.
  • Whether the claim is the first to be filed among competing claims.

Generally, the DOJ is interested in cases where the government loss is at least $1 million.

While the DOJ is deciding to intervene, the case is kept under seal which means the defendant can’t be notified about the claim. The DOJ normally has at least 60 days to decide whether to intervene or not.

Whistleblowers should consult with experienced qui tam attorneys before contacting the DOJ. There are specific requirements that must be met in order to qualify as a whistleblower. The lawyer can help the whistleblower assess the available evidence and whether more evidence should be obtained – so that as strong a case as possible is presented to the DOJ. If the DOJ declines to intervene, the whistleblower must use legal counsel to continue the claim. To review your whistleblower rights, call the experienced False Claims Act lawyers at the California Law Offices of Stephen A. Danz and Associates. For help now, call us at 877-789-9707 or use our online contact form to schedule an appointment. Se habla espanol.