Qui tam

Qui tam is a provision under the False Claims Act (31 U.S.C. § 3729 et seq.), which allows for a private individual, or whistleblower with knowledge of past or present fraud on the United States federal government to bring suit on behalf of the government. Its name is an abbreviation of the Latin phrase “qui tam pro domino rege quam pro se ipso in hoc parte sequitur,” meaning “he who [sues] for the king as well as for himself." This provision allows a private person, known as a “relator,” to bring a lawsuit on behalf of the United States, where the private person has information that the named defendant has knowingly submitted or caused the submission of false or fraudulent claims to the United States. The relator need not have been personally harmed by the defendant’s conduct. A private [natural] person may not be able to commence a qui tam action "pro se" -- that is, without representation by a lawyer -- since the private person is actually representing/filing the suit on behalf of the government and that may only be done by a lawyer.

How the False Claims Act Works

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The False Claims Act is a law that is designed to reward any person who knows that an individual or company has financially defrauded the federal government, by allowing that whistleblower to file a “qui tam” lawsuit to recover damages on the government’s behalf.

Medicare Fraud

In recent years, Medicare fraud and Medicaid fraud have been the two most active areas of qui tam litigation. It is estimated that Medicare fraud and other healthcare fraud cost the federal government billions of dollars each year. Accordingly, Medicare fraud qui tam lawsuits have been responsible for some of the government’s biggest health care fraud recoveries. The Warren Benson Law Group has obtained hundreds of millions of dollars in Medicare fraud whistleblower recoveries, and has represented Medicare fraud whistleblower clients in more than 30 states.

Some examples of fraud are:

• Billing more than once for the same service

• Charging for services not performed

• Offering free items or services in exchange for a Medicare or Medicaid number

• Billing for expensive equipment and only providing cheaper equipment

• Waiving copayments routinely

• Someone other than the physician completing the Certificate of Medical Necessity
  
  . .from http://www.expertlaw.com/library/employment/qui-tam.html