Relators (As amended July 21, 2010, P.L. 111-203)
When people speak of Abraham Lincoln, they do not mention “Lincoln’s law”, without which the Civil
War could have easily been lost. http://scholarship.law.uc.edu/cgi/viewcontent.cgi?article=1153&context=uclr
By 1863 the Whistleblower law was 100 years old. Government employees were receiving inferior or
useless war supplies, but generally, they did not report this. This phenomenon contributed to
losing the civil war. Congress passed the False Claim Act, to open fraud detection to civilian
“Relators” so if government recovered funds, “relators” got half; perpetrators could be made to pay
double or triple damages!
110 years later at our Bicentennial, the GAO Comptroller General reported 60% fraud levels in the
12-year-old Medicare and Medicaid programs. To stop this Congress passed the Medicare and Medicaid
Anti-Fraud Act. The Act set up Medicaid Fraud Control Units. These were ineffective for 10 years.
At that time, Congress amended the “False Claims Act of1986.” Subsequently, qui tam relators” filed
as many suits as government employee whistleblowers did. Pharmaceutical cases were the most
frequent defendants, even though 80% of the cases brought against them “disappeared” from
If you search the internet many articles and attorney’s ads for False Claim Act cases including
many on YouTube, “appear”.
The government believes that educating government providers and contractors on fraud will stop them from stealing from taxpayers. When they pay 1% back, they are absolved from punishment. Thousands of hours and millions in funds are spent “teaching” compliance of the False Claims Act laws. The Act has not stopped much fraud. Since 1980, nobody has been imprisoned for fraud and only a half of 1% has been recovered.
Medicare recipients “spin down” assets, to get Medicaid to pay for Nursing Homes as a QMB [over 65 and poor.] In 2004 CMS added nursing home patients, keeping them safe from abuse and neglect. This is now 40% of Medicaid costs. The number of employees in MFCU’s went down as case went up. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/2016-2017-Nursing-Home-Action-Plan.pdf
In March 2017, after 42 years of “working together” to end “Fraud in Government” the GAO released: “MEDICAID PROGRAM INTEGRITY: CMS Should Build on Current Oversight Efforts by Further Enhancing Collaboration with States”. Two months later the House voted to send Medicaid back to the states, with known high amounts of fraud. They doubled funds to state Medicaid plans while CMS tried to find and end of Medicare fraud from corporate providers! http://www.gao.gov/assets/690/683376.pdf