HSA 515: Health Care Policy, Law and Ethic
Qui Tam is Latin for “he who brings a case on behalf of our lord King, as well as for himself”. Qui Tam allows a private citizen (relator, whistleblower) to bring a lawsuit on behalf of the government, as well as himself, against a defendant who may has knowingly committed fraud or criminal act in which the government was victimized (Showalter, 2012). The private citizen need not have been personally harmed by the defendant’s conduct (Department of the Interior Office of Inspector General, 2010). The government can choose to take over the prosecution, but if the government declines the private citizen can proceed alone.
How Healthcare Qui Tam affects health care organizations.
Healthcare is a multi-billion dollar industry and has attracted those who want to defraud health insurance companies and the government (Showalter, 2012). Based on the healthcare industry monetary value it has become the fertile soil for white –collar crimes that end in criminal convictions and financial penalties (Showalter, 2012). The