Fed Court: Government Can Use Sample Evidence in Whistleblower Case
The False Claims Act exists to incentivize whistleblowing in areas such as Medicare fraud. Qui tam whistleblowers (known as “relators”) who bring the government’s attention to fraudulent practices of their employers or other institutions, are rewarded with a percentage of the recovery ranging from 15-30%. Proving the extent of a fraudulent practice can prove difficult, especially when employers go to great lengths to hide those practices.
Yesterday, in a win for whistleblowers and the U.S. government, a federal judge in Tennessee declared that government can extrapolate from a small sample of billing statements to show a significant amount of Medicare fraud.
The decision was especially important because there is relatively little case law on the question of whether extrapolation is an appropriate practice pursuant to the False Claims Act. The judge ruled that, “[t]he purpose of the FCA, as well as the development and expansion of government programs as to which it may be employed, support the use of statistical sampling in complex FCA actions where a claim-by-claim review is impracticable,” and added, “[i]f Congress intended to preclude statistical sampling from being used in this context, it has had ample opportunity to have that intention reflected in the language of the FCA.” (more…)