FCA Qui Tam Provisions (31 USC 3730(b))
Private whistleblowers (relators) may file civil FCA actions on behalf of the government under seal; DOJ investigates and may intervene; relators share in recoveries.
Primary source
31 USC 3730(b) — Office of the Law Revision Counsel →https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title31-section3730&num=0&edition=prelim
Verified May 23, 2026 · This is the authoritative regulator URL. The summary below is a research aid; the linked source controls.
31 USC 3730(b) authorizes any person (a "relator") to file a civil FCA action on behalf of the United States. The complaint is filed under seal, served on DOJ but not the defendant, and remains sealed at least 60 days (often extended) while DOJ investigates.
DOJ may intervene and take over the action, decline to intervene (leaving the relator to pursue), or move to dismiss under 3730(c)(2)(A) (the Granston memo authority).
Relator shares: 15-25% of recoveries when DOJ intervenes; 25-30% when DOJ declines and the relator litigates. Plus attorney's fees and costs.
The relator is typically a current or former employee, often a billing manager, compliance officer, or treating clinician. Anti-retaliation protection at 3730(h) makes termination or other adverse action against an employee who lawfully reported or pursued an FCA claim independently actionable.
Most healthcare FCA recoveries originate as qui tam matters. The structural lesson for practices: a functional internal compliance program — accessible reporting channel, documented investigation, demonstrable response — both reduces the underlying conduct and produces evidence of good faith if a relator suit later filed.
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Last reviewed May 23, 2026 · Citation verified May 23, 2026
Research aid, not legal advice. This summary is an administrative research aid prepared by D3rx. It does not certify compliance, provide legal advice, replace counsel, or guarantee an audit outcome. For authoritative regulatory text follow the primary source link at the top of this page. The practice remains responsible for reviewing, adopting, and maintaining its compliance program.