American Health Law Association - August 2022

The Typical Qui Tam Case Life Cycle

In a typical qui tam case, the sequence and life cycle follow a similar trajectory. The relator files a sealed qui tam complaint in a federal courthouse in the United States. While COVID has disrupted litigation, particularly complex False Claims Act (FCA) litigation, the basic case path still remains. Although the statute provides for a 60-day investigation period, cases may—and very often do—remain under seal for years. The defendant may or may not know about the sealed case. A Civil Investigative Demand (CID), or Health Insurance Portability and Accountability Act (HIPAA) subpoena, search warrant, or grand jury subpoena may place the defendant on constructive notice of an active civil and/or criminal investigation. The government often requests partial unsealing orders to engage the defendant in resolution discussions. Early resolution is not always successful. Fewer than 25% of the time, the government intervenes in some or all of the relator’s allegations.[1] Qui Tam complaints often contain both federal and state allegations that typically involve federal and state prosecutors along with myriad investigative agencies. These complaints often contain a 31 U.S.C. § 3730(h) retaliation claim, as well as other private causes of action. Sometimes the government takes no position. Other times the government declines to intervene in some or all of the allegations. Of significance to this...

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