Whistleblower cases and claims often need to use specialized or unique words and phrases in order to accurately describe the ins and outs of the legal processes. Because most of us aren’t familiar with whistleblowing terminology, we are presenting a number of the more-commonly used terms, acronyms, and expressions for you here, in alphabetical order.

Anti-Kickback Statute

Kickbacks are payments or compensation for facilitating a transaction and are illegal. The Medicare and Medicaid Patient Protection Act of 1987 has an anti-kickback statute, and violations of the statute can be the foundation for a qui tam or whistleblower suit.

Commodity Futures Trading Commission (CFTC)

An independent U.S. governmental agency that regulates the commodity and financial futures and options markets.

Covered Action

A legal action taken by the SEC that leads to monetary sanctions of more than $1 million.

Declined Case

The situation in which the government declines to join in a qui tam action after investigation, leaving the whistleblower to pursue it on their own. See Intervened Case.

Dodd-Frank Act

Signed into law in 2010, it reformed the financial regulatory system, notably providing increased incentives and protections for whistleblowers who expose various securities and financial violations to the SEC. The Act gives them a share of any money recovered, from 10 to 30 percent.

False Claims Act (Federal)

The federal False Claims Act (or Whistleblower Act) is also known as the “Lincoln Law” because it was first enacted in 1863 under President Lincoln. The Act provides incentives and protections to whistleblowers, giving them a share of any money recovered, from 15 to 30 percent. The Act has been amended numerous times, most recently in 2009. Some states also have false claims acts.

Intervened Case

The situation in which the government formally joins a qui tam action and then takes primary responsibility for pursuing the case. See Declined Case.

Off-Label Marketing

Promoting the use of a drug for a purpose other than that approved by the U.S. Food and Drug Administration (FDA). Off-label promotion by drug manufacturers, and the prescribing of drugs for off-label usage, can be False Claims Act violations because the off-label usage of drugs makes the drugs ineligible for Medicare and Medicaid reimbursement.

Protected Disclosure

A formal statement reporting serious wrongdoing such as corruption, fraud, false claims involving public money, or a public safety risk. A protected disclosure means that the reporting person—the whistleblower—is protected legally from reprisals or retaliation.

Qui Tam

An abbreviation from a longer Latin phrase, meaning “who sues for himself as well as for the king in this matter.” A qui tam action means that private citizens can file a suit in the name of the government, alleging fraud by those who receive government funds.

Relator

A whistleblower who brings a qui tam suit under a federal or state false claim act. A relator “relates” (or tells) facts on which a legal action is based.

Securities

Stocks, bonds and other financial instruments that have value, including derivatives.

Securities and Exchange Commission (SEC)

The regulatory agency that regulates the securities industry and markets, including the stock and options markets, and which enforces federal securities laws.

Stark Law

Regulates physician self-referral for Medicare and Medicaid patients, meaning that a doctor is prohibited from gaining financially from a referral for medical services or tests (some exceptions exist).

Unbundling

Breaking down medical procedures into individual components in order to gain a higher payment. This practice is considered fraud and can be a basis for Medicare whistleblowing.

Upcoding

Entering billing codes for medical procedures that result in a greater payment than if the correct billing code were used. This practice is considered fraud and can be a basis for Medicare whistleblowing.

Whistleblower

An individual who reports their concerns over fraud, corruption, or other crime they witnessed within a company, against the government, or that demonstrates a public safety risk. Internal whistleblowers bring their allegations within an organization, while external whistleblowers bring their allegations to law enforcement, government regulators, or media outlets.

When life goes wrong, we fight for what’s right.

If you have insider knowledge about governmental fraud, you could be entitled to a significant cash reward in a whistleblower suit. Whether it is Medicare fraud, tax fraud, defense contractor fraud, mortgage fraud, Medicaid or education fraud, or some other kind of fraud, an experienced whistleblower attorney  like the ones at the Louthian Law Firm can assess your case and help you file the necessary disclosure statement with the government if you have a valid case. In some instances, the government will “intervene” or take part in your lawsuit.

One of the most important reasons to contact a qualified whistleblower attorney is that you are much more likely to meet with success if your claim is clear, concise and substantive. The Louthian Law Firm can help you structure your claim in such a way that the government will be more likely to intervene in your case, possibly increasing the chances that you will recover reward money. Even if the government doesn’t decide to intervene, it might still be advisable to pursue your case without government involvement, with our strong support through every step of the process.

For a free, confidential evaluation of your case, call the Louthian Law Firm today at (803) 454-1200 or fill out the online consultation form. Louthian Law Firm. 80 years of experience—on your side.