On September 1, the U.S. Court of Appeals for the Eleventh Circuit issued its decision in United States ex rel. Zafirov v. Florida Medical Associates, LLC, a case concerning the qui tam provisions of the False Claims Act (FCA), vacating a lower court ruling that had found those provisions unconstitutional.
Qui Tam Actions
Broadly speaking, a “false claim” is a knowingly false or fraudulent claim for the payment of money or transfer of property that causes a loss to the federal government. The FCA applies, among other things, where a company or other person fraudulently obtains federal funds – for example, by overbilling under a government contract, billing for services that were never provided, or submitting false information to obtain government payments.
If a private individual, such as an employee of a company, learns of such misconduct, they may bring a civil action on behalf of the United States. Such a person is known as a qui tam relator. After the action is filed, the government decides whether to intervene and proceed with the action itself or decline to intervene and allow the relator to proceed.
If a qui tam action is successful, the relator receives a share of the recovery: between 15% and 25% if the government intervenes, and between 25% and 30% if the government declines to intervene and the relator proceeds with the action.
The qui tam mechanism is widely used in practice. According to the U.S. Department of Justice, whistleblowers filed a record 1,297 qui tam lawsuits in fiscal year 2025. Settlements and judgments in qui tam cases exceeded $5.3 billion, while approximately $330 million was paid to qui tam relators as awards.
The Clarissa Zafirov Case
The dispute before the Court of Appeals arose from an action brought by physician Clarissa Zafirov against her employer, Florida Medical Associates, LLC, doing business as VIPcare, and related entities. Zafirov alleged that the defendants artificially inflated the health status of patients enrolled in Medicare Advantage, including by reporting unsupported diagnoses. Because payments under the program are adjusted based on beneficiaries’ health status, Zafirov alleged that this enabled the companies to receive more money from the federal government than they were entitled to.
The United States initially declined to intervene in the case, and Zafirov therefore proceeded with the action herself.
In 2024, the defendants moved for judgment on the pleadings or dismissal, challenging the constitutionality of the FCA’s qui tam provisions on three grounds:
- first, they argued that relators exercise significant federal authority and therefore qualify as Officers of the United States, who must be appointed in the manner prescribed by the Constitution – by the President or, in certain cases, by the head of an executive department or a court – under the Appointments Clause;
- second, they argued that the qui tam provisions violate the Take Care Clause because the President lacks sufficient supervision and control over private relators who wield executive power;
- third, they argued that the provisions violate the Vesting Clause because relators have the executive power to bring civil enforcement actions on behalf of the United States, even though the Constitution vests that power in the President.
The U.S. District Court for the Middle District of Florida sustained the first argument. It held that a qui tam relator who pursues an enforcement action on behalf of the United States exercises significant federal authority and qualifies as an Officer of the United States. Because Zafirov had not been appointed in accordance with the Constitution, the court held that the FCA’s qui tam provisions violated the Appointments Clause and dismissed her action. It did not address the defendants’ other two constitutional arguments.
The Court of Appeals disagreed. It held that qui tam relators are not Officers of the United States because they do not occupy a “continuing position established by law”: a relator’s authority arises only in connection with a particular case and ends when that case ends. The constitutional requirements governing the appointment of federal officers therefore do not apply to them.
The court vacated the district court’s order dismissing the case and remanded the matter for further proceedings.
The district court will now have to consider the defendants’ two remaining constitutional arguments: whether the qui tam framework gives the President sufficient supervision and control over the exercise of executive power, and whether private individuals may constitutionally be given the authority to bring civil enforcement actions on behalf of the United States.
