False Claims Act, SEC, CFTC and IRS Whistleblower Programs: The Fraud Determines the Program

The False Claims Act versus SEC whistleblower distinction starts with what the fraud affects: government payments and obligations, or securities markets. A False Claims Act whistleblower can bring a court case over false claims for government money or money wrongfully kept from the government. The Securities and Exchange Commission addresses securities-law violations. If you know how a company changed the numbers, concealed a payment or misrepresented its work, the useful starting point is what those records were used to obtain.

Where the SEC, CFTC and IRS Programs Begin

The SEC, CFTC and IRS whistleblower programs concern securities, commodities and federal taxes:

• Securities fraud and other securities-law violations belong with the SEC whistleblower program.
• Violations of the Commodity Exchange Act belong with the Commodity Futures Trading Commission’s whistleblower program.
• Federal tax fraud belongs with the Internal Revenue Service’s whistleblower program.

We start with the conduct you can explain and the records behind it, then assess the appropriate program with False Claims Act, securities, commodities or tax whistleblower lawyers. You do not need to settle that question before speaking with us.

The False Claims Act Follows the Government Money

The False Claims Act reaches knowingly false claims for government money and false information that matters to those claims. It also reaches someone who causes another business to submit the claim. The company that lies and the company that sends the bill are not always the same company.

The law’s definition of a claim includes certain demands to contractors, grantees and other recipients using federally supplied or reimbursed funds to advance a government program or interest. A private company can sit between the business and the government payment. Public money. Private paperwork. We trace that relationship when assessing what your information shows.

In health care, the connection may be a billed service or diagnosis used to calculate a government payment. In government contracting, it may be product qualification, pricing data or a compliance certification. In research, it may be fabricated data supporting a federal grant application or progress report. The billing system, contract file and grant submission put different kinds of false information to the same use: obtaining public money.

A bank can face a False Claims Act case over government-backed mortgages. Wells Fargo agreed to a $1.2 billion civil settlement in April 2016. The Justice Department’s mortgage case concerned allegations that the bank certified ineligible loans for government mortgage insurance and failed to report defects. We look past the company’s industry label to the transaction that put taxpayer money at stake. Here, the government insured loans the bank allegedly should never have certified.

Money Owed to the Government Counts Too

A reverse false claim concerns money or property owed to the government. Knowing concealment or improper avoidance of that obligation can support a False Claims Act case. That includes certain overpayments a business is required to return.

The Congressional Research Service’s 2009 report, Qui Tam: The False Claims Act and Related Federal Statutes, explains an important feature of this part of the law: improper avoidance can occur without a new request for payment or a false document. For an insider, the decisive conduct may be the decision to retain money the business knows it owes.

Medicare and Medicaid overpayments illustrate the distinction. A healthcare business that knowingly keeps an overpayment after it is due back can face a False Claims Act case, even if the first payment was an honest mistake. We examine what the business knew about the overpayment and what it did with that knowledge.

Federal tax claims have a separate boundary: the False Claims Act excludes claims, records and statements made under the Internal Revenue Code. Customs duties can fall within the False Claims Act. For an importer, false origin or valuation information can be the means of withholding duties owed to the government. The kind of government obligation matters, and we examine it with you before deciding how to pursue the conduct.

The Evidence Connects the Falsehood to the Payment

A False Claims Act case connects the false claim or unpaid obligation to what the business knew and why the false information mattered to government payment. The insider’s account supplies the business context behind those connections.

A provider can bill for more care than its service records support. A contractor can conceal commercial discounts in the disclosures used to set its government prices. A grant application can rest on fabricated research data. In each, the false information reaches the government through the paperwork used to secure payment. We work with you to connect those records to the decisions that produced the false claim.

That is the substance behind the government’s examination of a false claim. We focus on the discrepancy, the payment it affected and the evidence of knowledge. Your familiarity with the work can explain why a number in an ordinary business record tells a very different story from the one the government received.

A Qui Tam Case Gives the Whistleblower a Role in Court

A qui tam case is a private court action brought in the government’s name. The False Claims Act gives the whistleblower a role in pursuing the case and a potential share of the recovery.

Our work with False Claims Act whistleblower lawyers connects your account of the business to that case. We work through questions about filing under seal with you, alongside the evidence that makes the case worth pursuing.

When the government joins, it takes primary responsibility for pursuing the action, and the whistleblower remains a party. That decision is government intervention.

Can I Continue If the Government Declines to Join?

Yes. The False Claims Act allows the whistleblower to continue the case when the government declines to join.

We examine the evidence and the work ahead with False Claims Act whistleblower lawyers who understand the industry involved. The relevant questions remain concrete: what was false, who knew it and how it affected government money.

What Share Is Possible?

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers. The whistleblower’s share comes from the recovery in the case.

Questions about anonymity or your own involvement are matters to discuss with us when we assess your case. We work through those questions about your situation with you.

Your Evidence Comes Before the Acronym

If you know what the company told the government, its investors or the market and why it was false, speak to one of our Whistleblower Experts about the conduct behind those records. We match your evidence to the right program, bring in False Claims Act, securities, commodities or tax whistleblower lawyers for your case, and stay beside you through its pursuit.