Do I Have a Qui Tam Case?
You suspect something is wrong — a billing pattern that does not add up, a contract that bills for work no one did, a kickback dressed up as a consulting fee. The question is whether what you have seen can actually become a case. This page walks through the eligibility questions a qui tam attorney would ask.
What This Page Covers
Four eligibility questions frame every qui tam evaluation: Does the fraud involve government money? Is your information non-public? Are you first to file? What evidence do you have?
You will also learn how the filing process works, what to do next, and the practical reasons to act promptly rather than wait.
The Four Eligibility Questions
A qui tam attorney would ask these questions in roughly this order. Answering yes to the first three and having real evidence on the fourth suggests you may have a viable claim.
Question 1: Does the fraud involve government money?
The False Claims Act covers fraud against federal funds and programs — Medicare, Medicaid, defense and infrastructure contracts, federal grants, customs duties, and similar. Many states have their own false claims statutes covering state funds. If the money being defrauded is purely private — one company cheating another with no government program involved — the qui tam framework generally does not apply.
Question 2: Is your information non-public?
Qui tam law rewards people who bring the government something it does not already know. The public disclosure bar can block a claim built entirely on information that was already public — in news reports, government audits, or court records — unless you are an original source with independent, material knowledge. First-hand information you gained through your work is exactly the kind of evidence the law is designed to reward.
Question 3: Are you first to file?
Under the first-to-file rule, only the first relator to bring a particular fraud claim can typically recover. If someone else has already filed a sealed case on the same conduct, a later filer may be barred entirely. This is why acting promptly — rather than waiting and gathering more — can matter enormously. You cannot see sealed cases, so the only way to secure your position is to file.
How to File a Qui Tam Lawsuit
The process is specific and not something to attempt alone. There is no public "qui tam complaint form" you simply fill out — the complaint is a formal legal pleading drafted to meet strict requirements.
Work With an Attorney
You work with an attorney to prepare a detailed complaint that satisfies Rule 9(b)'s heightened pleading standard and connects the alleged scheme to actual submitted claims. Most qui tam attorneys offer a free, confidential case review and work on contingency.
File Under Seal
The complaint is filed under seal in federal court, keeping it confidential from the defendant and the public. The seal is initially set for 60 days but is almost always extended while the government investigates.
Serve the Government
Simultaneously, you provide the government a written disclosure statement containing substantially all material evidence and information the relator possesses. A thorough, well-organized disclosure materially improves the odds of intervention.
Government Investigates
The case stays sealed while the Department of Justice investigates and decides whether to intervene. The relator cooperates with investigators and may provide additional analysis and documents.
Intervention or Declination
The government decides whether to intervene and take over the case or decline and let the relator proceed alone. Intervention strongly signals merit; declination carries a higher relator share but also greater cost and risk.
Timing Matters
Because of the first-to-file rule and a statute of limitations, the timing of these steps matters. Our case timeline page explains what happens after you file.
Question 4: What Evidence Do You Have?
A strong case rests on specific, first-hand evidence rather than general suspicion. You do not need to have assembled a complete case — that is the attorney's job — but the more concrete and specific your knowledge, the stronger your position.
Billing Records
Claims data showing upcoding, phantom billing, or unbundled procedures is among the most powerful evidence in healthcare fraud cases.
Internal Communications
Emails, memos, and meeting notes that show awareness of improper conduct can demonstrate the knowing element required under the False Claims Act.
Contracts and Financial Documents
Agreements that disguise kickbacks, false cost reports, or certifications of compliance that were untrue all support a qui tam complaint.
Direct Observations
Your own first-hand knowledge of how the scheme operated — who was involved, when it started, and how false claims reached the government — carries significant weight.
A Word of Caution
Gather what you lawfully have access to, but do not break laws or company policies to obtain documents, and be careful with protected health information. An attorney can guide you on what is appropriate.
Do Not Take Unauthorized Records
Employees cannot steal proprietary information or violate confidentiality obligations. Evidence must be lawfully obtained — your attorney will advise on proper collection once you establish a relationship.
Protect Health Information
HIPAA and similar rules apply to patient data. Work with counsel before removing or sharing protected health information from your workplace.
Act Before Someone Else Files
The first-to-file rule means only the first relator on a given fraud can usually recover. Waiting to gather more evidence can cost you the case entirely if another insider files first.
Keep the Matter Confidential
Do not discuss your concerns with coworkers who might alert management. Once a case is filed, the seal requirement prohibits public disclosure of the lawsuit.
What to Do Next
If you answered yes to the first three questions and have real evidence, you may well have a viable claim. The most useful next step is a confidential conversation with a qui tam attorney who can evaluate the specifics.
Request a Consultation
You can request a confidential consultation through QuitamOnline. Initial reviews are typically free and protected by attorney-client privilege.
Find Counsel
Browse our attorney directory to find experienced qui tam practitioners. FCA litigation is specialized — experience with these cases matters more than geography.
Understand the Road Ahead
Review our case timeline and whistleblower rewards pages so you know what to expect from filing through resolution.
Review Common Fraud Patterns
If your concerns involve healthcare billing, see our Medicare fraud examples to compare what you have observed against known schemes.
This page is general information, not legal advice, and reflects the law as of 2025–2026. See our disclaimer. QuitamOnline can help you take the next step.
Frequently Asked Questions
Is there a qui tam complaint form I can download?
No. A qui tam complaint is a formal court pleading drafted by an attorney to meet detailed legal standards, not a fill-in form.
How quickly do I need to act?
As soon as is practical. The first-to-file rule and the statute of limitations both reward prompt action, since only the first relator on a given fraud can usually recover.
Do I need a lawyer to file a qui tam case?
Yes. Qui tam cases must be filed in federal court under seal and meet strict pleading requirements, so experienced counsel is essential.
What if I'm not sure the fraud involves federal money?
That is one of the things a qui tam attorney will help you determine. Many cases involve a mix, and some states have parallel false claims laws.
Will it cost me anything to find out if I have a case?
Most qui tam attorneys offer a free, confidential case review and work on contingency, meaning fees come only from a recovery.
Explore Next
Continue with Case Timeline, Find an Attorney, or Contact Us.
Related guides
- FCA Original SourceHow the False Claims Act public disclosure bar and original-source exception work — and why independent insider knowledge matters for qui tam relators.
- How to File a Qui Tam LawsuitThe basic steps to file a qui tam lawsuit under the False Claims Act — from finding counsel to filing under seal and what happens after DOJ review.
- First-to-File RuleHow the False Claims Act first-to-file rule works — why only the first relator on the same fraud may proceed, and what whistleblowers should do to protect their claim.
- Relator MeaningIn qui tam law, the relator is the whistleblower who files a False Claims Act case on behalf of the government. Here is what the term means and how it differs from a typical plaintiff.