False Claims Act Case Process: From Filing to a Share of the Recovery

The False Claims Act case process begins with evidence review, a sealed complaint and a government investigation. A whistleblower can pursue a case with the government or continue after the government declines to take it over. A settlement or trial judgment can produce a recovery and a whistleblower share. If you know how a business obtained government money through false claims or kept money it owed, start with our whistleblower experts. We assess the evidence with you and bring in the whistleblower lawyers your case needs.

The Evidence Behind the Case

A False Claims Act case connects what happened inside a business to a false claim for government money or money the business owed the government. That includes evading customs duties. The important connections include what was false, who knew it, why it mattered to payment and what the government lost.

The payment request can be only the last part of that story. A recruitment policy can affect a university’s entitlement to federal student aid. Payments to surgeons can influence which products they use in operations billed to Medicare. The employee who understands the policy or the commercial arrangement may see the connection before anyone examining the bill does.

That is the work we begin with you. We examine the conduct, the payment and the decisions inside the organization, then bring in False Claims Act whistleblower lawyers with experience in that kind of case. Knowledge of the business gives the documents meaning: what the company promised, what it actually did and who understood the difference.

The Complaint and the Government’s Evidence Review

A qui tam complaint brings the whistleblower’s allegations to court in the government’s name. The government also receives a separate written disclosure of substantially all the material evidence and information the whistleblower possesses. The complaint tells the alleged story. The disclosure gives the government the evidence behind it.

Under the False Claims Act’s civil-action provisions, the complaint starts under seal while the government reviews the case. We work through questions about confidentiality and the case’s circumstances with you and the whistleblower lawyers handling it.

What the Government Investigates

The government can require documents, written answers and testimony while it investigates. A civil investigative demand gives it those powers before it decides whether to join a whistleblower case. The demand can reach someone holding relevant information, including someone who is not accused of wrongdoing.

The investigation also involves the agency whose program or money is at issue. The Justice Department’s instructions for handling civil fraud cases call for consultation with that agency during investigation, court proceedings and settlement. The agency’s views help establish whether the company’s statements were false and whether the difference mattered to payment.

That makes industry knowledge useful well beyond identifying an unusual bill. In a health care case, the product, referral arrangement and Medicare claim may explain different parts of the same transaction. In an education case, the connection may run from employee compensation to the school’s receipt of federal aid. The investigator needs the business explanation as well as the payment records.

Who Leads After the Government’s Review?

When the government intervenes, it takes primary responsibility for pursuing the case. The whistleblower, called the relator in the case, remains a party. When the government declines, the whistleblower has the right to continue through whistleblower counsel.

Can I Proceed After Declination?

Yes. The False Claims Act allows the whistleblower to continue after the government declines to take over. Declining is not a verdict on the case. The Justice Department’s own guidance recognizes that its decision may reflect how far it chooses to investigate with the resources available.

University of Phoenix shows what that can mean in practice. Two former employees alleged that the university accepted federal student aid while paying admissions counselors incentives tied to the number of students recruited. The government did not intervene, but supported the whistleblowers at several stages. In December 2009, the university agreed to pay $67.5 million to resolve those allegations.

The alleged conduct sat inside the university’s compensation system. The federal money arrived through student aid. Connecting the two was the case.

The Business Facts Behind the Court Case

Documents and witness testimony help develop the evidence as a case proceeds in court. Our work with you and False Claims Act whistleblower counsel keeps the business facts at the center: what the company represented, what happened inside it and how the two connect to government money.

Settlement or a Trial Decision

A case can reach a negotiated resolution with either the government or the whistleblower leading it. University of Phoenix illustrates the whistleblower-led route.

Precision Lens illustrates a healthcare case decided at trial. A federal civil jury found that the company paid kickbacks to ophthalmic surgeons to induce their use of its products in cataract operations reimbursed by Medicare. The Justice Department’s account of the case describes private-jet travel and luxury vacations, including ski trips and sporting events.

We see the distortion plainly: the supplier rewarded the surgeon whose product choices generated Medicare business. Taxpayers funded the operations. The vacation was part of the sales arrangement.

The government pursued the case through a coordinated effort involving the U.S. Attorney’s Office for the District of Minnesota, the Department of Health and Human Services Office of Inspector General and the FBI. The case began with a whistleblower.

Recovery and the Whistleblower’s Share

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

The Precision Lens resolution shows how the money connects to the case. The company and its former principal’s estate agreed to pay $12 million. In its July 2024 announcement, the Justice Department reported that it had collected nearly $27 million from the misconduct addressed in the case, including settlements with other participants.

In the University of Phoenix settlement, the Justice Department announced that the two former employees would receive $19 million from the proceeds. Their knowledge of the recruitment system helped bring the alleged misuse of student aid into a case that produced a settlement.

Your Knowledge Belongs at the Center

If you know how a company used false information to obtain government money or keep money it owed, speak with our whistleblower experts about building your case. We assess what your inside knowledge can prove, bring in False Claims Act whistleblower lawyers who understand the business involved, and work beside you from evidence review through resolution to build your strongest False Claims Act case.