CHC Whistleblower Protections and Reporting Mechanisms 1 — Questions and Answers
Question 1: Under the False Claims Act, what term describes a lawsuit filed by a private individual on behalf of the federal government to report fraud?
- Qui tam action (Correct answer)
- Class action
- Declaratory action
- Mandamus action
Correct answer: Qui tam action
A qui tam action allows a private individual (the relator) to sue on behalf of the federal government and share in any monetary recovery.
Question 2: What percentage of the government's recovery can a qui tam relator typically receive when the government intervenes in a False Claims Act case?
- 5–10%
- 15–30% (Correct answer)
- 35–50%
- 55–70%
Correct answer: 15–30%
When the government intervenes, the relator typically receives 15–30% of the recovery; the share is higher (25–30%) when the government does not intervene.
Question 3: Which federal law contains the primary anti-retaliation provisions protecting healthcare employees who report fraud against government programs?
- ERISA
- False Claims Act (Correct answer)
- OSHA Act
- EMTALA
Correct answer: False Claims Act
The False Claims Act's anti-retaliation provision (31 U.S.C. § 3730(h)) protects employees who report or assist in investigations of fraud against the government.
Question 4: Under the False Claims Act, what is the statute of limitations for filing a qui tam lawsuit?
- 1 year from discovery
- 3 years from the date of the violation
- 6 years from violation or 3 years after government knew, whichever is later (max 10 years) (Correct answer)
- 5 years from when the employer learned of the violation
Correct answer: 6 years from violation or 3 years after government knew, whichever is later (max 10 years)
FCA qui tam suits must be filed within 6 years of the violation or 3 years after the government knew or should have known, whichever is later, but no more than 10 years total.
Question 5: What remedies does the False Claims Act provide to a whistleblower who was wrongfully terminated for protected reporting activity?
- Reinstatement only
- Back pay only
- Reinstatement, double back pay, and attorneys' fees (Correct answer)
- Punitive damages capped at $10,000
Correct answer: Reinstatement, double back pay, and attorneys' fees
The FCA provides reinstatement to the same seniority level, double back pay, and special damages including attorneys' fees for employees who suffer retaliation.
Question 6: What is the 'first-to-file' rule under the False Claims Act?
- The government must file charges before a private relator can file suit
- Only the first qui tam complaint filed regarding a particular fraud scheme may proceed (Correct answer)
- Whistleblowers must report to their employer before filing suit in court
- The government has first right to all recovered funds before the relator receives a share
Correct answer: Only the first qui tam complaint filed regarding a particular fraud scheme may proceed
The first-to-file rule bars later-filed qui tam suits based on the same underlying facts as a pending prior action, preventing duplicative litigation.
Question 7: Which agency operates the primary federal hotline (1-800-HHS-TIPS) for reporting Medicare and Medicaid fraud?
- Centers for Medicare & Medicaid Services (CMS)
- Department of Justice (DOJ)
- Office of Inspector General (OIG) (Correct answer)
- Federal Bureau of Investigation (FBI)
Correct answer: Office of Inspector General (OIG)
The HHS Office of Inspector General operates the OIG Hotline to receive and triage reports of fraud, waste, and abuse in HHS programs including Medicare and Medicaid.
CHC Whistleblower Protections and Reporting Mechanisms 1
Under the False Claims Act, what term describes a lawsuit filed by a private individual on behalf of the federal government to report fraud?