How Federal False Claims Act Cases Work

Last updated on August 13, 2026

The federal budget is nearly $4 trillion per year. A large percentage of this huge outlay is payment and reimbursement for goods and services. The government has systems in place to prevent fraudulent claims, but these systems are hardly foolproof. This is why the government relies on individuals (formally called “relators” but often just called “whistleblowers”) to come forward with evidence of fraud. Cases filed by whistleblowers have a much higher success rate than cases filed solely by the government. The government’s policies and laws mandating sharing rewards with whistleblowers are major factors in this success.

The False Claims Act (FCA) is the government’s most powerful tool in combating waste, fraud and abuse. It came into existence during the Civil War to quash procurement fraud by vendors eager for government money – thus its early identification as “Lincoln’s Law.” The law was substantially overhauled in 1985.

Who Can File A Federal False Claims Act Lawsuit?

The federal FCA covers fraud involving government programs, contracts and federally funded services. You may qualify if you are:

• An employee who witnessed fraud at your workplace involving federal funds
• A contractor or subcontractor working on a government-funded project
• Another party with inside knowledge of fraud against a federal program or contract

Timing matters in these cases. Under the first-to-file rule, only the first person to report a given fraud can share in the recovery. To file, you must also retain an attorney since the law does not allow individuals to bring these cases without legal counsel.

What Types Of Fraud Does The Federal False Claims Act Cover?

The FCA reaches a wide range of fraudulent conduct directed at the federal government. You may have grounds for a case if, at your workplace, you have witnessed any of the following actions involving government funds:

• Medicare and Medicaid fraud: Billing the government for undelivered services, upcoding medical procedures or paying illegal kickbacks for patient referrals
• Defense contractor fraud: Overcharging the military, delivering substandard equipment or misrepresenting performance on a government contract
• Construction contractor fraud: Falsifying certifications, inflating costs or substituting inferior materials on federally funded projects
• Cybersecurity fraud: Misrepresenting compliance with federal cybersecurity requirements to win or keep government contracts
• Tax fraud: Filing false returns or concealing taxable income, covered under the New York False Claims Act and other state False Claims Acts, rather than the federal FCA

We have handled federal FCA cases in federal courts across the country for over 20 years. Our practice focuses exclusively on representing whistleblowers; we never represent the companies on the other side of these cases.

What Happens When You File A Qui Tam Case?

A qui tam case begins with a complaint filed by the whistleblower in a U.S. District Court. The whistleblower is asking the federal government to intervene, and prosecutors must evaluate the evidence to make this decision.

Copies are shared with the local United States attorney and the U.S. Attorney General. Defendants named in the complaint are not informed about it, nor is information made available to the public. The majority of jurisdictions only allow these cases to be brought by lawyers acting on their clients’ behalf. The cases cannot be brought by individuals without representation.

Our work as your representatives is intensive during this period. At Fischer Legal Group, we know the federal FCA process and are familiar with its many requirements. We will ensure that you have the standing to file the complaint. To prevent confusion and “piling on,” the government only allows the first whistleblower to file a complaint in a given case to share in the damages. For a detailed breakdown of each stage – from the initial sealed filing through the government’s review period and beyond – see our overview of how the qui tam process works.

What If The Government Declines To Intervene?

After reviewing a sealed qui tam complaint, the Department of Justice may decline to intervene. This decision does not mean the government found that no fraud occurred. It means the government chose not to take the lead in the case then.

You may still continue the lawsuit as the relator. When the government intervenes, and the case leads to a recovery, the relator generally receives 15% to 25% of the proceeds. When the government declines, and the relator continues successfully, the share generally rises to 25% to 30%.

A declined case places more work on private counsel. Your legal team must lead discovery, answer defense motions and prepare for settlement or trial without the government directing the case. This added role can increase cost and risk.

Fischer Legal Group has guided whistleblowers through intervened and declined cases. We will review the specific evidence, explain the risks and help you decide whether proceeding supports your goals.

What Is The Scope Of The Rewards You May Receive?

Defendants convicted of FCA violations generally pay back three times the amount of losses by the government due to the fraud. In addition, the courts may levy civil penalties between $14,308 and $28,619 per fraudulent claim.

Violations of the FCA can result in other negative consequences, including disqualification from future federal and state government contracts.

The rewards for whistleblowers in the conviction are significant. Relators are awarded a share of 15% to 30% of government recoveries. Every case has its own complexities, which may affect your total reward. At Fischer Legal Group, we will give you the information necessary to estimate your total compensation for reporting the crime.

Fischer Legal Group Case Results

The firm has represented whistleblowers in False Claims Act cases involving health care, wage violations and public program fraud. These results show that the firm has handled records, worked with government agencies and pursued difficult claims.

In the Americare matter, a whistleblower report made in 2017 helped uncover wage violations affecting more than 10,000 home health aides and raised concerns about Medicaid billing. The final resolution required Americare to return nearly $45 million in unpaid wages and pay another $10 million to New York’s Medicaid program, bringing the total to $55 million. This matter shows how one person’s information can lead to a wider review of worker pay and the misuse of government funds.

Fischer Legal Group also served as counsel in Rubino v. Waldman with attorney Audrey Schechter. This federal False Claims Act case involved an alleged COVID-19 testing scheme in which the complaint claimed that Medicare was billed for costly laboratory tests that patients did not receive. The matter ended in a $5 million settlement.

Together, these matters reflect the firm’s direct work on large FCA claims and its ability to guide complex whistleblower cases from review through resolution.

Whistleblower Anti-Retaliation Protections

The federal FCA prohibits employers from retaliating against any employee, contractor or agent who files or assists in an FCA lawsuit. Retaliation can include termination, demotion, suspension, harassment or other adverse employment actions. If your employer retaliates against you for coming forward, the law gives you the right to take action.

Remedies for retaliation under the FCA include reinstatement to your previous position, double back pay and compensation for additional damages you have suffered. Importantly, these protections apply even if the government does not intervene in your case or the underlying fraud claim does not succeed.

Effective Whistleblower Representation

This is not a simple part of the law by any means. Call Fischer Legal Group at 212-577-9231 or email us to arrange an initial consultation to fully understand the dimensions of your case.