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by Neil V. Getnick and Lesley Ann Skillen
Published in the New York Law Journal, October 22, 1996
October 1996 marks the 10th anniversary of the 1986 amendments
to the Federal False Claims Act, 31 USC § 3729 et. seq., a
century-old statute whose "whistleblower" -- or qui tam
-- provisions have returned over $ 1 billion in defrauded funds
to the federal government in the past decade by empowering citizens
to become private fraud enforcers.
New York City's Public Advocate, and the State Attorney General
each have introduced legislation to follow this lead in New York.
The False Claims Act, including its qui tam provisions, was initially
enacted at the urging of President Abraham Lincoln in 1863, a few
months before the Battle of Gettysburg. A response to reports of
widespread fraud by Civil War profiteers, the Act encouraged citizens
with knowledge of fraud against the government to come forward by
authorizing them to file a civil suit in the name of the government
and be awarded a percentage of the recovery.
Although the "Lincoln Law" was a warime initiative, it
was not limited to defense fraud and covered all types of fraud
against the government. In 1863, private citizen enforcement was
an integral part of the U.S. statutory framework. As a California
court noted in 1989, the qui tam laws "are firmly rooted in
the American legal tradition."
Like the Congressional initiative that resulted in the original
False Claims Act, the 1986 amendments were prompted by reports of
pervasive fraud against federal agencies, notably defense procurement
and health care fraud. A revamped and revitalized qui tam law was
seen as a powerful and effective means of addressing these problems.
"[Only] a coordinated effort of both the Government and the
citizenry," wrote the Senate Committee on the Judiciary, "will
decrease this wave of defrauding public funds."
Legislative Framework
Today's Federal False Claims Act provides for treble damages and
penalties of $ 5,000-10,000 per violation for almost any false claim
or false statement (other than tax fraud) that involves payment
or a demand for payment from the federal government, or which deprives
it of revenues in some way. The "knowing" submission of
false claims includes not just actual knowledge, but also deliberate
ignorance and reckless disregard for the truth. The qui tam provisions
of the statue permit a private citizen (individual or corporation)
-- known as the "relator" -- with knowledge of a violation
of the statue to receive up to 30 percent of the recovery, with
the average share hovering around 18 percent. Courts are authorized
to reduce the percentage share of a relator who "planned and
initiated" the wrongdoing, and a relator who is criminally
convicted must be dismissed from the action. Qui tam actions "based
on" information that has been the subject of a "public
disclosure" are jurisdictionally barred, unless the relator
is an "original source of the information," as defined
in the statue. This prohibition on "parasitic" qui tam
suits ensures that suits cannot be filed by persons who have made
no substantial contribution to uncovering and reporting the essential
elements of the case.
The 1986 amendments also created a federal cause of action for
employment discrimination arising from acts performed in furtherance
of qui tam action, providing for double the amount of back pay plus
interest, reinstatement and compensation for special damages. The
employee need not be a qui tam relator in order to bring an action
under this section.
Practice
The success of the 1986 amendments was acknowledge by the Department
of Justice in October 1995, marking the $ 1 billion recovery point.
The Assistant Attorney General for the Civil Division, Frank Hunger,
praised the 1986 bipartisan effort of Senator Charles Grassley and
Representative Howard Berman as a work of "leadership and vision
. . . The recovery of over $ 1 billion demonstrates that the public-private
partnership encouraged by the statue works and is an effective tool
in our continuing fight against the fraudulent use of public funds."
While defense fraud and health care fraud still account for most
qui tam cases, the number of cases involving other agencies is increasing.
A random sample of recent qui tam cases brought in other fields
includes cases involving construction and housing, environmental
compliance, scientific research, agricultural subsidies and orders,
banking, securities, and telecommunications. The qui tam law has
also been used to sue state governments and agencies for fraud in
federally-funded state-administered programs.
The largest single recovery in a qui tam suit to date was in April
1994, when defense contractor United Technologies Corporation agreed
to pay the government $ 150 million in settlement of a qui tam action
commenced by an executive vice president, Douglas Keeth. The largest
health care fraud recovery was $ 111 million paid by National Health
Laboratories in November 1993 following a qui tam case brought by
Jack Dowden, then a sales manager with a rival diagnostic testing
laboratory. The government is investigating similar practices by
other national laboratories and, according to press reports, mutli-million
dollar settlements are imminent.
Qui tam actions have been brought by companies as well as by discontented
employees. In 1995, for example, a Florida medical equipment distribution
company received a share of a $ 5 million settlement following a
qui tam action against Huntleigh Healthcare, a manufacturer of lymphedema
pumps. The qui tam action brought by the company's president, Ron
Wells, alleged that Huntleigh had promoted one of its low-grade
pumps (sold wholesale for less than $ 500) as a more sophisticated
pump eligible for a Medicare reimbursement of $ 4,000. Wells's business
had suffered as sales of the pump by his competitors soared. Wells
used the qui tam law to level the playing field by exposing the
illegal practices of his competitors and offsetting the business
losses he incurred as a result.
Four states -- Florida, Tennessee, Illinois and California -- have
followed the federal lead by enacting False Claims Acts to combat
fraud committed against their own programs. In New York State and
City during the past year, two bills have been introduced to enact
similar legislation.
The New York City Public Advocate's false claims legislation for
New York City was introduced into the City Council in Nov. 16, 1995.
The bill is closely modeled on the Federal False Claims Acts.
State Attorney General Dennis Vacco introduced a proposed False
Claims and False Information Act into the State Legislature on April
11, 1996. The bill departs in many material respects from the federal
legislation. In its present form, the bill assigns a level of control
of the qui tam process ot the Attorney General that is entirely
absent in the federal statue and that will undercut the ability
of the state law to duplicate that success. For example: certification
by the Attorney General is a condition precedent to the filing of
a qui tam action; the Attorney General may withdraw a certification
or convert a qui tam action into an Attorney General civil enforcement
action during the course of the action; and the Attorney General
may remove the qui tam plaintiff from an action in his discretion
if certain conditions are present. Further, the relator's share
of the recovery is determined by the Attorney General and may be
as little as $ 1,000 or as much as 40 percent of the proceeds. Under
the Federal Act, the relator receives a percentage of the proceeds;
there are no fixed sum payments, and the relator's share is determined
by the court.
Conclusion
The qui tam law serves the public interest by encouraging private
parties (both individuals and corporations) with knowledge of fraud
against public funds to come forward and to assist the government
in seeking recovery. The monetary reward provides a financial incentive
to "do the right thing," particularly for employees whose
whistleblowing acts involve the risk of isolation, dismissal, demotion
and/or permanent career injury. Qui tam actions can also provide
compensation to corporations and business people whose market share
has suffered as a result of fraudulent, anti-competitive and abusive
practices in their industry.
The qui tam law also has a deterrent impact. Qui tam has raised
the stakes of committing and concealing fraud by creating an army
of private citizen watchdogs, by providing specific remedies for
employer retaliation, and by heavily penalizing those who get caught.
The Federal False Claims Act and its state equivalents have provided
governments with a more powerful and more flexible means of recovering
defrauded funds than common law claims, regulatory actions and civil
penalty statues. As the New York State Bar Association's Federal
and Commercial Litigation Section concluded in a report issued in
May a statue applying to New York State and its political subdivisions
would provide New York with a comparable level of protection from
illicit profiteering at the expense of State and local taxpayers.

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