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The Data Scientist

False Claims

How the False Claims Act Works, Step by Step

You saw something. Perhaps the numbers were off, or the government was billed for work that never occurred. Or someone fudged results on a contract that got federal dollars.

Being caught in the middle of something like that can feel isolating, especially when a coworker is involved in the deception. But the False Claims Act exists for this exact reason. It gives you a path to report fraud, protects you from retaliation, and lets you file on the government’s behalf. The steps matter, though. What you do next can shape everything that follows. Let us walk through it.

Step 1: Find Out if It Is Fraud

“The False Claims Act only applies when someone knowingly submits a false claim to the federal government to get paid,” says criminal attorney Bill Nettles of Bill Nettles, Attorney at Law. “Before you move forward, it is important to understand whether what you saw crosses that line. Without that, the law may not protect you.”

Here is what you need to do to find out if what you suspect is fraud:

  • Start with the money trail: The first thing to check is whether the company receives federal funds. That includes programs like Medicaid or federally backed loan programs. If they do, ask what was claimed, what was delivered, and whether the two line up. The law only applies if a false claim was made.
  • Look for a pattern: One-off errors happen. Fraud, on the other hand, often follows a script. When the same red flag shows up across multiple claims, the explanation shifts. 

 

Once you are certain that this involves false claims submitted to the federal government, your first step is to find a lawyer, as it is mandatory. Individuals are not allowed to file False Claims Act cases on their own.

Your attorney will file the case under seal. That means the lawsuit is hidden from public records, search tools, and the defendant. Nobody sees it. The point is to give the government time to investigate without interference. While the seal is officially 60 days, that deadline rarely sticks. The government typically requests additional time, and courts often grant it.

And, after the case is filed, you are legally required to remain silent. That means no conversations about the lawsuit at work, at home, or even with the people closest to you. The court treats confidentiality as non-negotiable. If you speak about the case before the seal is lifted, you could jeopardize the investigation and violate a federal order.

Step 3: The Government Decides What to Do Next

While the case remains sealed, the Department of Justice reads through what your attorney submitted. This includes your declaration, supporting documents, and any evidence you can provide to support your claim of fraud. Their job is to decide if this case is worth stepping into.

If they intervene, the government takes control. You remain involved, but they lead the investigation. They can issue subpoenas, question witnesses, and prosecute the defendant. That level of access lends weight to the case.

If they decline, you can still move forward. You and your lawyer continue the case in the government’s name, but without its investigative powers. That path is possible, but more demanding.

Once the government has made its decision, the case is unsealed. The defendant sees it, and the public can verify it. If you face backlash at work, the False Claims Act protects you from retaliation, including firings, pay cuts, and missed promotions.

Conclusion

If the DOJ steps in and recovers funds, the whistleblower may qualify for a percentage of that recovery. The amount depends on several factors, including how the case was constructed and when it was filed. Timing matters. So does the strength of your evidence. The way your lawyer presents the case can shape how the government responds.