The False Claims Act is the federal law that allows healthcare insiders to file a lawsuit on behalf of the government and receive a share of any financial recovery. If you have witnessed Medicare or Medicaid fraud, you may have a qui tam claim. Reach out for a confidential conversation. There is no obligation.
The False Claims Act is the federal law that allows healthcare insiders to file a lawsuit on behalf of the government and receive a share of any financial recovery. If you have witnessed Medicare or Medicaid fraud, you may have a qui tam claim. Reach out for a confidential conversation. There is no obligation.
The False Claims Act is the primary federal statute that prohibits submitting false or fraudulent claims for payment to the United States government. This includes claims submitted to Medicare, Medicaid, TRICARE, and other federal healthcare programs. It is also the law that gives healthcare insiders the legal mechanism to come forward, expose fraud, and share in any financial recovery the government obtains.
Enacted during the Civil War and substantially strengthened by Congress in 1986, the False Claims Act has become the federal government’s most powerful civil enforcement tool against fraud. In fiscal year 2025, the Department of Justice recovered more than $6.8 billion through False Claims Act settlements and judgments, the highest single-year total in the history of the statute. Of that total, more than $5.7 billion came from healthcare-related fraud. Since 1986, total recoveries under the False Claims Act have exceeded $85 billion.
$6.8 billion recovered by the DOJ through False Claims Act enforcement in fiscal year 2025, the highest annual total in the statute’s history. More than $5.7 billion of that total involved healthcare fraud.
Source: U.S. Department of Justice, FCA Statistics FY 2025, January 2026
A qui tam lawsuit is filed by a private individual, called a relator, on behalf of the federal government under the False Claims Act. The relator brings the evidence. The government investigates. If there is a financial recovery, the relator is eligible to receive a share of it.
The term comes from the Latin phrase “qui tam pro domino rege quam pro se ipso in hac parte sequitur,” meaning “he who sues on behalf of the king as well as for himself.” It describes the dual role of the whistleblower: you are suing both for the government and for yourself.
The complaint is filed under seal with the federal court and served on the Department of Justice and any state agencies that have been impacted by the alleged fraud. This means the case is not public during the investigation period. Your employer does not receive a copy. The government investigates privately, and the seal is maintained until the DOJ decides whether to intervene.
In fiscal year 2025, whistleblowers filed 1,297 qui tam lawsuits, the highest number in a single year in the history of the False Claims Act. False Claims Act cases resulted in more than $5.3 billion in settlements and judgments in 2025.
The strongest qui tam cases come from current or former employees of healthcare organizations who have direct, first-hand knowledge of fraud from inside the organization. This includes billing specialists and medical coders, office staff and administrators, nurses, physicians, and clinical staff, compliance officers and executives, pharmacists and pharmaceutical staff, home health aides, physical and occupational therapists, and hospital and health system employees.
You do not need to be a current employee. Former employees file successful qui tam cases regularly, provided the claim is filed within the applicable statute of limitations. You do not need documents or conclusive proof before reaching out. If you have credible, first-hand knowledge of what you believe is fraud against a federal healthcare program, that is enough to start a confidential conversation.
If the government intervenes and takes over the case
If the government declines and you proceed independently
There is no cap on the dollar amount of the reward. The exact percentage within these ranges depends on factors including the significance of your contribution to the case and whether you had any role in the underlying conduct. We work on contingency. There is no upfront cost. If there is no recovery, you owe us nothing.
The False Claims Act imposes serious civil penalties on organizations and individuals who submit false claims to the federal government. These penalties apply in addition to the repayment of damages.
For violations occurring after November 2, 2015, and assessed after July 3, 2025, civil penalties range from $14,308 to $28,619 per false claim, plus three times the amount of damages the government sustained. A single fraudulent billing practice affecting thousands of claims can result in total liability in the tens or hundreds of millions of dollars.
| Penalty Component | Amount |
|---|---|
| Civil penalty per false claim (minimum) | $14,308 |
| Civil penalty per false claim (maximum) | $28,619 |
| Damages multiplier | 3x the amount of government loss (treble damages) |
The False Claims Act prohibits your employer from firing, demoting, suspending, harassing, or discriminating against you because you reported fraud or participated in a qui tam case. These protections apply to current and former employees.
If your employer retaliates against you, you have legal remedies that include reinstatement to your position, two times the amount of back pay you lost, interest on that back pay, and compensation for any special damages including litigation costs and attorney fees.
Your identity is protected from the moment you file. The complaint is submitted under seal. Your employer is not notified. The investigation proceeds without disclosing your name. Attorney-client privilege applies from your first contact with us.
Step 1: Confidential consultation. You speak with an attorney from Khurana Law Firm in complete confidence. Nothing you share is disclosed to anyone. Attorney-client privilege applies immediately.
Step 2: Case investigation. We investigate the facts thoroughly before asking you to sign anything. We evaluate the merits, assess the evidence, and give you an honest picture of whether you have a viable case. If we do not believe the case is strong enough, we will tell you directly.
Step 3: Disclosure statement and complaint. If we proceed, we prepare a confidential disclosure statement for the Department of Justice and a sealed complaint for filing in federal court. The disclosure statement is one of the most important documents in the case. It is what the DOJ uses to decide how to conduct its investigation.
Step 4: Government investigation. The DOJ and relevant federal and state agencies, including the HHS Office of Inspector General, investigate privately. The seal is maintained during this period. These investigations can take a year or longer for complex cases.
Step 5: Intervention or declination. The government decides whether to intervene and take over the case, or decline. If the government declines, you may still proceed independently. Declined cases have resulted in significant recoveries for whistleblowers.
Step 6: Resolution. The case resolves through settlement, judgment, or in rare cases trial. If there is a recovery, your relator share is paid from the proceeds.
The False Claims Act requires that a qui tam complaint be filed within six years of the date the fraud occurred. There is a secondary rule that permits filing within three years of when the government knew or should have known about the fraud, but no case may be filed more than ten years after the underlying violation.
The six-year rule governs most cases. If you are aware of fraud that occurred several years ago, the time to act may be limited. An experienced attorney can assess whether your case is within the filing window and take immediate steps to preserve your claim.
The False Claims Act also has a first-to-file rule. Only the first person to file a qui tam lawsuit based on a specific set of facts can receive the whistleblower reward for that case. If another relator has already filed a complaint covering the same underlying conduct, a later complaint on the same facts will likely be dismissed. This is one of the strongest reasons not to delay.
Arvind Bob Khurana has over 27 years of experience in qui tam and False Claims Act litigation, complex commercial litigation, and class action matters. He began his career at a top international defense firm and joined a national class action firm in 2005, becoming partner in 2009, where he worked on ERISA actions, qui tam cases, securities fraud, and antitrust matters. He is admitted to the New York State Bar and represents whistleblowers in federal courts nationwide.
We are selective. Before we ask for any commitment, we investigate the claim, explain the facts and the risks, and give you a complete picture of what you are facing. We never ask you to sign a retainer agreement until you have the full picture and have decided, on your own terms, that you want to move forward. You remain in control throughout.
Arvind Bob Khurana has over 27 years of experience in complex litigation. We work on contingency. There is no upfront cost and no obligation to proceed.
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