The Problem—Government Fraud

Every year government fraud costs American taxpayers billions of dollars. Medicare fraud is a prime example. In 2013, Medicare financed health care services for approximately 51 million Americans at a cost of about $604 billion. While not all of these payments were fraudulent, the FBI estimates that anywhere from 3-10% of all payments made in the Medicare system may be the result of fraud. Across all sectors of the United States government, improper payments are estimated to exceed $125 billion.

The United States Government is working hard to fight back against those seeking to profit by stealing from American taxpayers. For instance, in 2013 more than $2.6 billion dollars was recovered related to health care fraud, with more than $3.8 billion across all sectors of the federal government. While these recoveries are significant, it still means that fraudsters are making off with billions in taxpayer dollars every year.

The Solution—You

America needs your help. The sheer size of Medicare and other government programs makes it difficult for enforcement agencies to pursue all but the largest and most brazen offenders. However, under the False Claims Act, private citizens with evidence of government fraud can file lawsuits to help the United States Government recover its losses due to fraud.

Claims brought by private citizens under the False Claims Act are called qui tam actions, where a concerned citizen (often referred to as a “whistleblower”) essentially stands in the shoes of the government. When successful, whistleblowers in a qui tam action are entitled to recover between 15-25% of the amounts recovered. This means that when the fraud is large enough, whistleblowers can end up receiving millions of dollars for their efforts.


Often times, a potential whistleblower is concerned about losing his or her job, because the individual or entity or entity guilty of fraud is his/her employer. The False Claims Act offers two layers of protection to whistleblower employees. First, qui tam actions are initially filed under seal, which means that no one outside of court personnel, the responsible enforcement agency, and the whistleblower are aware that a suit was filed. In addition, federal law prohibits any sort of retaliatory action against a whistleblower making a good faith claim.

Government fraud can take a variety of forms:

  • Health care, Medicare and Medicaid fraud
  • Upcoding
  • Phantom Billing
  • Off-label marketing of prescription drugs
  • Kickbacks
  • Fraud by defense contractors
  • Procurement of contracts

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