The Department of Justice declines to intervene in the vast majority of whistleblower cases. Attorney James D. Young sheds light on what the government looks for in a qui tam case.
The government has a number of factors that it uses to determine whether or not to intervene in a case.
Some of those factors are: the amount of money that’s been involved in the fraud, how criminal the conduct--the underlying fraudulent conduct. Was it a true criminal conspiracy, or was it a mistake?
Is there strong a public policy that’s implicated by it--in other words, is action needed in this particular instance to affect a broader sweeping change in healthcare or defense contractors…
Is there patient harm involved? Often, when there’s fraud that results in unnecessary treatment to patients, if that treatment is harming them (in the case of pharmaceuticals, medical devices, and unnecessary procedures), the government is quicker to step in and intervene in the case.