Purpose of This Template
The Eleventh Circuit recently affirmed that the False Claims Act's qui tam provisions align with the U.S. Constitution, allowing private citizens to file lawsuits on behalf of the government against entities defrauding federal programs. This decision strengthens the legal basis for whistleblower actions under the False Claims Act.
For you and your team managing ethics and hotline programs, this ruling means your internal reporting channels might receive concerns that could develop into qui tam actions. You need a structured approach to handle reports of potential government fraud without discouraging legitimate concerns or creating liability.
This template provides a conversation script for intake specialists and ethics officers who receive reports involving potential False Claims Act violations. It helps you acknowledge the concern, explain reporting options (both internal and external), and document the conversation without pressuring the reporter.
Prerequisites
Before using this script, ensure:
- Your intake team understands the difference between internal investigations and qui tam actions (the latter involve private citizens suing on behalf of the government, often with legal representation).
- You've reviewed your organization's contracts with federal agencies, Medicare/Medicaid billing practices, or other government interactions that could trigger False Claims Act exposure.
- Your legal team has briefed you on how your organization wants to handle reports that mention overbilling, false certifications, or kickbacks related to government contracts.
- You have a clear escalation path to legal counsel when a report suggests potential government fraud.
You don't need to be a lawyer to use this script. You need to listen carefully, document accurately, and know when to involve legal.
The Template
Opening (when the reporter describes potential government fraud)
"Thank you for bringing this to our attention. What you're describing sounds like it involves [government contracts/Medicare billing/federal grant compliance]. I want to make sure you understand your options because concerns like this can be reported internally through our process, directly to government agencies, or both. Let me walk you through what each path looks like."
Explaining Internal Reporting
"If you report this through our internal channels, here's what happens: [Your intake specialist or I] will document your concern, and our [compliance/legal/audit] team will investigate. We're required to protect you from retaliation for making a good-faith report. The investigation findings stay confidential to the extent possible, and if we find a problem, we're obligated to correct it and, in some cases, self-report to the government."
Explaining External Options (False Claims Act Context)
"You also have the legal right to report suspected fraud against the government directly to the Department of Justice or to file what's called a qui tam lawsuit. That's a legal action where a private citizen can sue on behalf of the government. If the government recovers money because of your lawsuit, you may be entitled to a percentage of that recovery. Those cases are typically handled by attorneys who specialize in False Claims Act work."
"I'm not a lawyer, so I can't advise you on which path is better for your situation. If you're considering a qui tam action, you should talk to an attorney before you decide. What I can tell you is that filing internally and filing externally aren't mutually exclusive. Some people do both."
Clarifying Your Role
"My job is to take your report seriously and make sure it's investigated if you choose to report internally. I can't stop you from reporting externally, and we can't retaliate against you for doing so. What I need from you right now is: Do you want to file an internal report with us? And separately, do you want information about how to contact government agencies or find a qui tam attorney?"
Documentation and Next Steps
"I'm going to document this conversation, including the fact that I explained your reporting options. If you decide to proceed with an internal report, I'll [describe your standard intake process]. If you need time to think about it or consult with an attorney, that's completely reasonable. Here's how to reach me when you're ready."
If the Reporter Asks Whether They Should File Externally
"I can't answer that for you. That's a legal and personal decision. What I can tell you is that our organization takes these concerns seriously, and if there's a problem, we want to fix it. But I also understand that you may have reasons to pursue this through legal channels, and that's your right."
How to Customize It
Adjust for Your Organization's Government Exposure:
If you don't have federal contracts or Medicare billing, simplify the opening to focus on the type of government interaction you do have. If you're a defense contractor, be more specific: "concerns about certification accuracy on government contracts."
Match Your Escalation Protocol:
Replace bracketed placeholders with your actual process. If reports involving potential government fraud go straight to your General Counsel, say so. If you have a specialized government contracts compliance team, name them.
Tailor the Retaliation Language:
Use the exact anti-retaliation commitment from your Standards of Business Conduct or whistleblower policy. If you have specific protections (like a formal non-retaliation investigation process), reference them.
Add Resources:
If your legal team has approved a one-page explainer on qui tam actions or a list of external reporting contacts (DOJ hotline, Office of Inspector General for your industry), offer to send it. Don't create this resource yourself; legal should vet it.
Consider Timing:
If the reporter is already consulting an attorney, your script shifts. You might say: "I understand you're working with legal counsel. I still want to document your concern internally. Would you like to proceed with an internal report, or would you prefer to have your attorney contact us?"
Validation Steps
After customizing this script, validate it with these steps:
Legal Review:
Your General Counsel or Outside Business Activities counsel should review the final script to confirm it doesn't inadvertently discourage protected activity or create enforceable commitments you can't keep. The Eleventh Circuit's ruling reinforces that qui tam actions are constitutionally sound, so your script must respect that right.
Test with Intake Staff:
Role-play the conversation with your hotline operators or ethics officers. Do they feel confident delivering it? Can they answer follow-up questions without veering into legal advice?
Check for Pressure:
Read the script aloud and listen for anything that sounds like you're steering the reporter away from external reporting. Phrases like "it's better to handle this internally" or "you should try our process first" can create legal risk. Stick to neutral explanation.
Confirm Documentation:
Make sure your case management system has fields to capture: (1) that you explained external reporting options, (2) whether the reporter indicated they're considering a qui tam action, and (3) whether they proceeded with an internal report. This documentation protects both the reporter and your organization.
Update Annually:
Qui tam case law evolves. The Eleventh Circuit's decision is current as of this writing, but other circuits may rule differently, or the Supreme Court may weigh in. Schedule an annual review with legal to confirm your script still reflects the current legal landscape.
This script won't prevent every qui tam lawsuit. That's not the goal. The goal is to handle these sensitive reports with integrity, protect the reporter's rights, and give your organization a chance to investigate and remediate before external action becomes necessary. When you do that well, you're supporting the same accountability that the False Claims Act was designed to create.
