The False Claims Act’s qui tam provisions are among the federal government’s most important tools for identifying and pursuing alleged fraud involving Medicare, Medicaid, federal health care programs and other government funds. The statute permits a private individual, known as a relator, to bring a False Claims Act action “for the person and for the United States Government” in the name of the government. 31 U.S.C. § 3730(b)(1). If the action succeeds, the relator may receive a share of the recovery. Id. § 3730(d). For health care providers, pharmacies, manufacturers, contractors and others that submit claims to or receive funds from the federal government, qui tam litigation has long been a significant source of False Claims Act exposure.
That enforcement structure faced a serious constitutional challenge after a federal district court in Florida held in 2024 that the False Claims Act’s qui tam provisions violate the Appointments Clause of Article II. United States ex rel. Zafirov v. Florida Medical Associates, LLC, 751 F. Supp. 3d 1293 (M.D. Fla. 2024). On September 1, 2026, the U.S. Court of Appeals for the Eleventh Circuit reversed. The appellate court held that a False Claims Act relator is not an “Officer of the United States” because the relator does not occupy a continuing position established by law. United States ex rel. Zafirov v. Florida Medical Associates, LLC, No. 24-13581 (11th Cir. Sept. 1, 2026). The decision preserves the existing qui tam framework, but...
The False Claims Act’s qui tam provisions are among the federal government’s most important tools for identifying and pursuing alleged fraud involving Medicare, Medicaid, federal health care progra...