The Eleventh Circuit Court of Appeals issued a significant ruling on September 1, 2026, concerning the constitutionality of qui tam provisions in the False Claims Act (FCA). The court ruled that these provisions do not violate the Appointments Clause of the Constitution. This decision affects whistleblowers and their ability to report fraud against the government, particularly in healthcare cases involving Medicare.
The case, Clarissa Zafirov v. Florida Medical Associates, LLC (Docket No. 24-13581), arose when Dr. Clarissa Zafirov, a former employee, alleged that her employer submitted false claims to Medicare. The ruling has implications for how qui tam actions are pursued and the authority of relators, or whistleblowers, in these cases.
Background
Dr. Clarissa Zafirov filed her qui tam action in 2019 against Florida Medical Associates and several related entities. She claimed that these companies knowingly submitted false diagnosis codes to receive higher payments from Medicare, a federal health insurance program. The case was litigated for several years until the defendants sought dismissal, arguing that the qui tam provisions of the FCA were unconstitutional.
The defendants contended that the qui tam provisions violated the Appointments Clause, which requires that federal officers be appointed by the President. They argued that relators like Zafirov should be considered officers because they exercise significant authority and hold a continuing position. The district court agreed with the defendants, ruling that the qui tam provisions were unconstitutional and dismissing the case.
The Ruling
The Eleventh Circuit Court disagreed with the district court's ruling. The court determined that relators do not qualify as officers of the United States because they do not occupy a continuing position established by law. The court stated, "We hold that relators are not officers of the United States because they do not occupy a continuing position established by law." This ruling aligns with decisions from other circuit courts that have addressed similar issues.
The court vacated the district court's order and remanded the case for further evaluation of the defendants' remaining constitutional arguments. The judges on the panel included Circuit Judges Branch and Luck, along with District Judge Moreno, who sat by designation.
Impact
This ruling is significant for the future of qui tam actions under the FCA. By affirming that relators are not considered federal officers, the court has reinforced the ability of whistleblowers to pursue claims of fraud without needing presidential appointment. This decision may encourage more individuals to come forward with information about fraud against the government, particularly in healthcare sectors where such fraud is prevalent.
Moreover, the ruling clarifies the legal standing of relators in the context of the Appointments Clause, potentially setting a precedent for similar cases in the future. The court's decision may also influence how lower courts handle constitutional challenges to the FCA's qui tam provisions.
What's Next
The case has been sent back to the district court for further proceedings regarding the remaining constitutional arguments raised by the defendants. It remains to be seen whether the defendants will appeal this ruling or if there will be additional related cases that arise as a result of this decision.