A RELATOR BRINGS THE LAWSUIT
The False Claims Act, or Qui Tam Law, is designed to encourage citizens to expose fraud. The person who exposes the fraud, and who brings the lawsuit on behalf of the government, is called a relator.
Qui Tam is derived from Latin. “Qui tam pro domino rege quam pro se imposo sequitur” means “who brings the action as well for the king as for himself”. U.S. v. St. Luke's Episcopal Hosp, et al. , 982 F. Supp. 1261, 1262 (S.D.Tex. 1997)].
A Qui Tam Plaintiff or Relator is a person who discovers facts that constitute a fraud perpetrated against the government, facts that also prove a violation of the false claims act. The Relator may bring these facts to an attorney that specializes in qui tam litigation who can then access the merits of the case, initiate or complete an investigation as necessary, accumulate the evidence that details the fraud and then file a Qui Tam Complaint for the government and the Relator. In some factual scenarios there may be a federal case, a state case and a class action suit based upon the same set of facts.
WHAT IS MEDICARE FRAUD?
Are healthcare regulations being complied with at your office? Are your office's healthcare practices and procedures different than those required by healthcare regulations? Are two sets of patient records being maintained in separate locations?
A Medicare or other healthcare fraud case may surface from information given by a disgruntled employee in an employment action. For instance, a healthcare provider may coerce an employee to do some act that the employee knows is unethical, wrong, fraudulent, or criminal, related to Medicare or Medicaid billing, reporting, or cost accounting. When the employee refuses to cooperate, they may be labeled a trouble-maker and fired.