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FOR PUBLICATION
In the
United States Court of Appeals
For the Eleventh Circuit
No. 24-13581
UNITED STATES OF AMERICA,
Movant-Appellant,
CLARISSA ZAFIROV,
ex rel; Dr.,
Plaintiff-Appellant,
versus
FLORIDA MEDICAL ASSOCIATES, LLC,
d.b.a. VIPCARE,
PHYSICIAN PARTNERS, LLC,
ANION TECHNOLOGIES, LLC,
FREEDOM HEALTH, INC.,
OPTIMUM HEALTHCARE, INC.,
Defendants-Appellees,
PHYSICIAN PARTNERS SPECIALITY SERVICES, LLC, et al.,
Defendants.
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2 Opinion of the Court 24-13581
Appeal from the United States District Court
for the Middle District of Florida
D.C. Docket No. 8:19-cv-01236-KKM-SPF
Before BRANCH, LUCK, Circuit Judges, and MORENO,* District
Judge.
BRANCH, Circuit Judge:
The False Claims Act (“FCA”) allows the Attorney General
to bring civil suits against perpetrators of fraud against the
government. This case involves another portion of the FCA—the
qui tam provisions—which allow people, called relators, who have
knowledge about fraud against the government to pursue a case
against the perpetrator of the fraud.
Here, a relator brought an FCA suit against defendants that
she alleged committed Medicare fraud, and the defendants moved
for judgment on the pleadings or dismissal on the grounds that the
qui tam provisions violated the Constitution’s Appointments
Clause, Take Care Clause, and Vesting Clause. The district court
granted the defendants’ motion and held that the qui tam
provisions violate Article II’s Appointments Clause 1 because
* Honorable Federico A. Moreno, United States District Judge for the Southern
District of Florida, sitting by designation.
1 The Appointments Clause of Article II of the Constitution provides that the
President “shall nominate, and by and with the Advice and Consent of the
Senate, shall appoint . . . Officers of the United States.” U.S. Const. art. II, § 2,
cl. 2.
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24-13581 Opinion of the Court 3
relators qualify as officers of the United States and, as such, must
be (but are not) presidentially appointed.
We disagree and hold that relators are not officers of the
United States because they do not occupy a continuing position
established by law. Accordingly, we join our sister circuits that
have addressed this issue and hold that the qui tam provisions of
the FCA do not violate the Appointments Clause. 2 Therefore, we
vacate the district court’s order dismissing this case and remand for
the district court to evaluate the defendants’ remaining
constitutional arguments.
I. Procedural Background
In 2019, Dr. Clarissa Zafirov brought this qui tam action
under the FCA on behalf of the United States against her employer
and related entities, Florida Medical Associates (d/b/a VipCare);
Physician Partners, LLC; Anion Technologies, LLC; Freedom
Health, Inc.; and Optimum Healthcare, Inc. Zafirov alleged that
the defendants knowingly submitted false diagnosis codes to
receive more money than they were entitled to from Medicare, a
federal health insurance program. The parties litigated the case for
several years until February 2024, when the defendants moved for
judgment on the pleadings or dismissal of the case. The defendants
2 See Riley v. St. Luke’s Episcopal Hosp., 252 F.3d 749, 758 (5th Cir. 2001)
(en banc); United States ex rel. Taxpayers Against Fraud v. Gen. Elec. Co., 41 F.3d
1032, 1041 (6th Cir. 1994); United States ex rel. Kelly v. Boeing Co., 9 F.3d 743,
757–59 (9th Cir. 1993); United States ex rel. Stone v. Rockwell Int’l Corp., 282 F.3d
787, 804–05 (10th Cir. 2002).
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argued that the qui tam provisions violated Article II’s
(1) Appointments Clause because relators exercise significant
federal authority in a continuing position without appointment by
the President; (2) Take Care Clause because the President lacks
sufficient supervision and control over relators who wield
executive power; and (3) Vesting Clause because relators have the
executive power to bring civil enforcement actions on behalf of the
United States while the Constitution vests that power in the
President alone. Although the United States declined to intervene
in the case when it was first filed, it intervened after the defendants
raised these constitutional challenges “for the limited purpose of
defending the constitutionality of the qui tam provisions of the
[FCA].”
The district court determined that the qui tam provisions
violated the Appointments Clause, so it did not address the
defendants’ Take Care Clause or Vesting Clause arguments. United
States ex rel. Zafirov v. Fla. Med. Assocs., LLC, 751 F. Supp. 3d 1293,
1304 (M.D. Fla. 2024). The district court made three central
findings in its Appointments Clause analysis. Id. First, it concluded
that relators are officers of the United States. Id. To make that
determination, the district court used the test from Lucia v. SEC,
585 U.S. 237 (2018), that differentiates between government
officers and mere employees to whom the Appointments Clause
does not apply. Zafirov, 751 F. Supp. 3d at 1306–07. The Lucia test
states that an individual is an officer if he “exercise[s] significant
authority pursuant to the laws of the United States” and “occup[ies]
a ‘continuing’ position established by law.” Lucia, 585 U.S. at 245
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(quoting United States v. Germaine, 99 U.S. 508, 511 (1879)). The
district court held that relators’ civil enforcement authority
constitutes “significant authority” because similar enforcement
authority qualifies FEC commissioners and special prosecutors as
government officers. Zafirov, 751 F. Supp. 3d at 1307–09. The
district court also held that relators occupy a continuing position—
an “office of relator.” Id. at 1313–17. The court reasoned that “the
office of relator exists whether a person is appointed to that office
or not, making that office ‘continuous and permanent.’” Id. at
1314. And, the district court stated, it does not matter that relators
act for only a single case. Id. at 1314–15. Second, the district court
was unpersuaded that historical examples of similar qui tam
provisions from the founding era justify the FCA’s
constitutionality. Id. at 1317–22. Third, it determined that Zafirov
was not presidentially appointed, which the parties did not contest.
Id. at 1304, 1322.
After finding that the qui tam provisions of the FCA violated
the Appointments Clause, the district court dismissed the case
because Zafirov was “the only litigant on her side of the
enforcement action” and lacked authority to prosecute on behalf
of the United States. Id. at 1323.
We now turn to an overview of the relevant provisions of
the FCA.
II. FCA Background
The FCA imposes civil liability for certain deceptive
practices involving government property, including “knowingly
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present[ing] . . . a false or fraudulent claim for payment or
approval.” 31 U.S.C. § 3729(a)(1)(A). Also liable are those who
“knowingly make[] [or] use[] . . . a false record or statement
material to a false or fraudulent claim.” Id. § 3729(a)(1)(B). Each
individual FCA violation carries a statutory penalty and treble
damages. Id. § 3729(a).
The Attorney General can bring a civil action under the
FCA. Id. § 3730(a). But private parties called relators can also bring
an action “for the person and for the United States Government”
that is brought “in the name of the Government” through the qui
tam provisions of the FCA. Id. § 3730(b)(1). Various statutory
mechanisms govern the respective roles of the relator and the
government in qui tam actions. For example, when a relator first
files a complaint, it remains under seal for at least sixty days while
the government determines how it wants to proceed. See id.
§ 3730(b)(2). Those sixty days are referred to as “the seal period.”
United States ex rel. Polansky v. Exec. Health Res., Inc., 599 U.S. 419,
426 (2023). During the seal period, the government has two
options: it can intervene and proceed with the action itself, or it can
decline to intervene and allow the relator to proceed. 31 U.S.C.
§ 3730(b)(4)(A)–(B). If the government intervenes—then, or later
upon a showing of good cause—it may also dismiss the action over
the relator’s objection. Id. § 3730(c)(2)(A), (c)(3); Polansky, 599 U.S.
at 425–27. While dismissal must be approved by the court, the
court applies the typical voluntary dismissal rule (Federal Rule of
Civil Procedure 41) and must provide the government “substantial
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deference” and grant dismissal in “all but the most exceptional
cases.” Polansky, 599 U.S. at 437.
Relators are entitled to compensation when they are
involved in a successful FCA qui tam suit. 31 U.S.C. § 3730(d). The
relator can receive a contingent fee of up to 30% of the proceeds of
the case or settlement of the action, with the exact award based on
whether the government intervened and on the extent of the
relator’s contributions to prosecuting the action. Id.
With this statutory framework in mind, we now turn to the
merits of the constitutional challenge to the FCA.
III. Discussion
Zafirov and the United States argue that the qui tam
provisions of the FCA are consistent with the Constitution’s
Appointments Clause, Take Care Clause, and Vesting Clause. We
address only the qui tam provisions’ constitutionality under the
Appointments Clause and remand for the district court to consider
the Take Care Clause and Vesting Clause arguments in the first
instance.3
While the parties agree that relators are not presidentially
appointed, Zafirov and the United States argue that the
3 “[W]e review de novo the constitutionality of a statute because it is a question
of law.” United States v. Wright, 607 F.3d 708, 715 (11th Cir. 2010). A court
should invalidate an act of Congress only “for the most compelling
constitutional reasons.” Mistretta v. United States, 488 U.S. 361, 384 (1989)
(quoting Bowsher v. Synar, 478 U.S. 714, 736 (1986)).
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Appointments Clause does not require relators to be presidentially
appointed because (1) relators are private parties pursuing a private
interest and do not exercise executive power; (2) relators do not
exercise significant authority; and (3) relators do not occupy a
continuing position.
Zafirov and the United States are correct that relators do not
hold a continuing position, which is sufficient to determine that
relators are not officers who must be presidentially appointed.
Accordingly, we need not reach any of their remaining arguments.
The Appointments Clause of Article II of the Constitution
requires that the President “shall nominate, and by and with the
Advice and Consent of the Senate, shall appoint . . . Officers of the
United States.” U.S. Const. art. II, § 2, cl. 2. Two “requirement[s]”
determine whether a government employee is an officer of the
United States: first, he must “occupy a ‘continuing’ position
established by law”; second, he must “exercise significant authority
pursuant to the laws of the United States.” Lucia, 585 U.S. at 245
(alteration adopted) (first quoting Germaine, 99 U.S. at 511; and
then quoting Buckley v. Valeo, 424 U.S. 1, 126 (1976) (per curiam)). 4
“[T]he term [officer] embraces the ideas of tenure, duration,
emolument, and duties.” Germaine, 99 U.S. at 511. So in
determining whether a person holds a continuing position
established by law, the Supreme Court has evaluated whether that
person holds a “permanent” tenure, whether his employment has
4 We assume without deciding that Lucia’s framework governs relators, who
are not government employees.
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“duration as to time,” and whether he receives a “continuing
emolument.” Auffmordt v. Hedden, 137 U.S. 310, 327–28 (1890);
Germaine, 99 U.S. at 511–12. And with respect to “duties,” Chief
Justice Marshall asked “if [the] duties continue, though the person
be changed.”5 United States v. Maurice, 26 F. Cas. 1211, 1214 (C.C.D.
Va. 1823) (No. 15,747) (Marshall, C.J.); see also Auffmordt, 137 U.S.
at 327 (relying on Maurice in a continuing-position analysis).
Zafirov and the United States argue that relators do not
occupy a continuing position because (1) any position they have is
temporary; (2) they do not receive a continuing emolument; and
(3) their duties are personal because if the relator drops out of a
case, nobody can replace him. On the other hand, the defendants
argue that in certain circumstances a new relator can take over an
existing case from a previous relator and that the FCA created a
continuous “office of relator” that relators can occupy for years at
a time given the length of some FCA cases. Zafirov and the United
States are correct: relators do not hold a continuing position.
5 The district court looked to a framework created by the Second Circuit for
determining whether a position is “continuing.” Zafirov, 751 F. Supp. 3d at
1315–16. That framework considers whether (1) the position is not personal
to a particular individual; (2) the position is not transient or fleeting; and
(3) the duties of the position are more than incidental. See United States v.
Donziger, 38 F.4th 290, 297 (2d Cir. 2022). The Second Circuit’s test reflects its
own distillation of Supreme Court caselaw. Id. That test is not binding on this
Court, and we decline to adopt it; instead, we rely directly on the guidance the
Supreme Court has provided. See Commodores Ent. Corp. v. McClary, 879 F.3d
1114, 1133 (11th Cir. 2018) (“[W]e are not bound by the determinations of
another circuit court.”).
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First, we address a relator’s tenure and determine whether
it is “permanent” as opposed to “occasional or temporary.”
Germaine, 99 U.S. at 511–12. In Germaine, the Supreme Court held
that a surgeon appointed by the Commissioner of Pensions to
examine pension applicants did not have a permanent tenure
because he acted only “when some . . . claimant of a pension
present[ed] himself for examination,” so the surgeon may have
conducted “fifty of these examinations in a year, or none.” Id. at
512. In addition to focusing on the “intermittent” nature of the
surgeon’s duties, the Court relied on the fact that the surgeon was
not required to keep a place of business. Id. The Court conducted
a similar analysis in Auffmordt when it held that a merchant
appraiser responsible for appraising imported merchandise had an
occasional and temporary role because he had “no general
functions” and acted only “occasionally” when an emergency arose
and his expertise was requested for a reappraisal. 137 U.S. at 326–
27. Like the surgeon in Germaine and the appraiser in Auffmordt, a
relator’s tenure is occasional and temporary because it lasts the
length of one case, a relator may bring multiple cases in a year or
none, and relators are not required to keep a place of business. And
if, for example, the government or the court dismisses a relator’s
case or if the case settles, the relator has no remaining duties.
Accordingly, a relator’s intermittent, nonpermanent tenure tends
to show that he does not hold a continuing position. See id.
We now turn to the duration of a relator’s role. While the
defendants argue that some relators pursue FCA cases for several
years, that fact does not alter our conclusion that relators do not
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hold a continuing position. It is true that some relators litigate
actions for multiple years (while others may have their cases
dismissed within the 60-day seal period), but the Supreme Court
has not focused on the overall length of a person’s time fulfilling
his duties when evaluating the duration of the position. For
example, in Germaine the Court recognized that the surgeon
appointed to examine pension applicants could act in his role for at
least a year. See 99 U.S. at 512. But it did not say that the duration
of the surgeon’s role therefore indicated that the surgeon held a
continuing position. See id. Instead, the Court evaluated duration
the same way it assessed “tenure”—by asking whether the
surgeon’s duties were “permanent” or “occasional and
intermittent.” Id. at 511–12. In Auffmordt, the Court again analyzed
tenure and duration in tandem and held that the customs appraiser
did not have a role with “any duration as to time” because his
employment did not “extend[] over any case further than as he is
selected to act in that particular case.” 137 U.S. at 327. As we
described above, a relator does not have a permanent tenure, and
he therefore does not have a position with duration that makes him
an officer; a relator’s duties do not “extend[] over any case further
than as he is selected to act” when the government declines to
intervene. See id.
Next, we turn to another critical characteristic of an officer:
that he receives a “continuing emolument.” Auffmordt, 137 U.S. at
327. To the extent that a relator’s entitlement to a portion of the
judgment in a successful FCA case can be considered an
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“emolument,”6 it certainly is not “continuing.” See id. The
Supreme Court’s decision in Germaine is again instructive on the
issue of a “continuing” emolument. There, the Court held that the
surgeon appointed to examine pension applicants did not receive a
continuing emolument and was thus not an officer of the United
States because (1) the surgeon was paid an amount contingent on
the number of examinations he performed; (2) “[n]o regular
appropriation [was] made to pay his compensation”; (3) he worked
on an “occasional and intermittent” basis; and (4) there was “no
penalty for his absence from duty or refusal to perform, except his
loss of the fee in the given case.” Germaine, 99 U.S. at 512.
Similarly, a relator (1) only receives payment as a one-time award
contingent on the success of his case; (2) receives compensation
through a portion of the judgment, if any, not through any regular
appropriation; (3) works on an intermittent basis (whenever he has
a claim to pursue and the litigation is active); and (4) faces no
penalty for a refusal to perform except for the loss of his
opportunity to receive a contingent fee for succeeding in a given
case. See 31 U.S.C. § 3730(d). Like a relator’s intermittent tenure,
his lack of a continuing emolument counsels finding that he is not
an officer of the United States.
Finally, we assess a relator’s duties. A relator occupies a
personal role, not one where his “duties continue, though the
6 An emolument is “[a]ny advantage, profit, or gain received as a result of one’s
employment or one’s holding of office.” Emolument, Black’s Law Dictionary
(12th ed. 2024).
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person be changed.” See Maurice, 26 F. Cas. at 1214. A relator
assumes a duty to litigate each case that he files, and his role in the
case cannot be assumed by anybody else (except for the Attorney
General when the government intervenes). See 31 U.S.C.
§ 3730(b)(5); id. § 3730(b)(4)(A), (c)(1). The defendants resist this
conclusion, claiming that one relator can replace another if a
relator who filed an FCA claim “dies or goes into bankruptcy.” The
defendants’ argument mischaracterizes what happens when a
relator dies or goes bankrupt. In those instances, another relator
does not replace the deceased or bankrupt; instead, a personal
representative or trustee of the relator’s estate can carry forward
the case on his behalf. See United States v. NEC Corp., 11 F.3d 136,
139 (11th Cir. 1993) (allowing an FCA qui tam suit to continue after
a relator died with that relator’s personal representative continuing
to pursue the action); see also United States ex rel. Spicer v. Westbrook,
751 F.3d 354, 364 (5th Cir. 2014) (holding bankruptcy trustee was
proper party to bring FCA claim belonging to relator’s bankruptcy
estate). So even in the limited contexts where a relator dies or goes
bankrupt, the role of relator remains personal because the relator
is not replaced; his estate carries forward the claim on his behalf.
The fact that a relator’s duties are personal and cannot be assumed
by others points to the position of relator not being a continuing
one.7 See Maurice, 26 F. Cas. at 1214.
7 Relatedly, the defendants cite Kellogg Brown & Root Services, Inc. v. United
States ex rel. Carter, 575 U.S. 650 (2015), for the proposition that the “office of
relator” is not personal and exists independent of the person bringing a qui
tam action because “if a relator’s complaint is dismissed on procedural
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In sum, we find that, while the length of any given FCA case
is uncertain and variable, relators have temporary tenure and
duration, no continuing emolument, and personal duties, so they
do not occupy a continuing position.
None of the defendants’ counterarguments are persuasive.
To begin, the defendants point to Morrison v. Olson, 487 U.S. 654
(1988), to support their argument that relators hold continuing
positions. But the personal role of relators is easily distinguishable
from the independent counsel the Supreme Court held was an
officer in Morrison. Morrison concerned a statute that “allow[ed] for
the appointment of an ‘independent counsel’ to investigate and, if
appropriate, prosecute certain high-ranking Government officials
for violations of federal criminal laws.” Id. at 660. The Supreme
Court held that an independent counsel served a “temporary” role
and was “appointed essentially to accomplish a single task,” but
was nonetheless an officer of the United States. Id. at 672. Like the
independent counsel at issue in Morrison, relators have “no ongoing
responsibilities that extend beyond the accomplishment of [a
defined] mission.” Id. But unlike relators, independent counsels
grounds, another relator may step into the role and raise the same claims.”
The defendants misunderstand the holding in Carter. Nothing in Carter
authorizes one relator to “step into the role” and assume a qui tam action for
another. Instead, Carter simply held that an FCA action dismissed on
procedural grounds is no longer “pending” for purposes of the statute and
therefore does not bar a later separate FCA action that raises the same claims
as the prior dismissed action. See 575 U.S. at 662–64. Carter does not
undermine our conclusion that the role of a relator is personal and not a
continuing office.
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did not have duties that were personal. If an independent counsel
resigned or was removed, his replacement picked up the work right
where his predecessor left off, even if it was in the middle of a case
or investigation. See id. at 661 n.5. In fact, picking up the work of
the prior independent counsel is exactly what happened in
Morrison—Morrison, the appellant, was appointed as independent
counsel when James C. McKay, the previous independent counsel,
resigned. Id. at 667. Morrison was McKay’s “replacement, with
the same jurisdiction.” Id. In contrast, the FCA’s qui tam
provisions do not provide any mechanism for a relator to be
replaced if they “resign” by abandoning their claim. And
independent counsels were on “the public payroll,” id. at 683, as
part of a “permanent indefinite appropriation . . . within the
Department of Justice.” 28 U.S.C. § 594; Pub. L. No. 100-202, Title
II, 101 Stat. 1329 (1987). A relator, on the other hand, simply takes
a portion of the judgment or settlement that he helps the
government obtain, which is not an appropriation, much less a
regular one. So, while Morrison demonstrates that a position’s
temporary nature is not sufficient on its own to show that a role is
not continuing, other aspects of a relator’s role—the lack of a
continuing emolument or continuing duties—clearly distinguish
relators from officers such as independent counsel.8 And despite
8 The defendants note “another helpful analogy” by the district court in which
the district court compared relators to bank receivers who are officers of the
United States even though their duties last for only a single receivership. We
do not read the defendants’ brief as pressing a separate argument based on a
bank receiver analogy because the defendants mention this analogy in passing USCA11 Case: 24-13581 Document: 169-1 Date Filed: 09/01/2026 Page: 16 of 18
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the defendants’ argument to the contrary, relators occupy a role
comparable to the customs appraiser in Auffmordt, who was not an
officer. The Supreme Court held that the customs appraiser did
not occupy a continuing position because he was “selected for [a]
particular case” and “for his special knowledge,” and he did not
have any “general functions.” Auffmordt, 137 U.S. at 327. Similarly,
relators have special knowledge about fraud in a particular case but
fulfill no general functions. See 31 U.S.C. § 3730(e)(4)(A) (requiring
dismissal, unless the government opposes, of actions based on
allegations publicly disclosed in enumerated channels, unless the
relator is an original source).
Finally, the defendants argue that the FCA created an “office
of relator” that is continuous regardless of the status of any one
case because various private parties can become relators and
occupy the office of relator at any time. So, the defendants argue,
quoting from the district court’s dismissal order, “the office of
relator is ‘continuous even if it is not continually filled,’ and it is
generally held at any given time by numerous private parties
conducting litigation on behalf of the United States.” First, we note
and do not provide any analysis. See Sapuppo v. Allstate Floridian Ins. Co., 739
F.3d 678, 682 (11th Cir. 2014) (explaining that a party fails to adequately press
an issue when it simply makes passing references to a matter in a brief without
supporting arguments and authorities). In any event, like independent
counsel, when receivers died or were removed, a successor took over their
duties—the position was not “vacate[d].” See Stanton v. Wilkeson, 22 F. Cas.
1074, 1075 (S.D.N.Y. 1876). In other words, the duties of the receivership
continued “though the person [was] changed.” Maurice, 26 F. Cas. at 1214.
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that there is no “office of relator”; that term is not in the FCA or
any other law. Second, the defendants’ argument improperly
analyzes whether the office is a continuing one, when the proper
inquiry is whether an individual occupies a continuing position. To
determine whether a position is continuing, the Supreme Court
has looked at the specific actions the individual undertakes as part
of his role in that position and other characteristics of the role when
it is filled. 9 See, e.g., Auffmordt, 137 U.S. at 327 (considering the
scope of the occupier’s duties and whether they include “general
functions”); Germaine, 99 U.S. at 512 (analyzing the frequency of
duties the position required and its compensation structure). Even
accepting the defendants’ framing that there is an unfilled “office of
relator,” no precedent has ever looked at the existence of an
unfilled position and determined that because it could be filled (e.g.,
by a relator filing a complaint), the individual that fills that position
occupies “a ‘continuing’ position established by law.” Lucia, 585
U.S. at 245 (quoting Germaine, 99 U.S. at 511). We decline to do so
for the first time in this case.
Because we conclude that relators do not occupy a
continuing position, we hold that relators are not officers of the
United States subject to the Appointments Clause.
9 An evaluation of the fictional “office of relator” departs from the Supreme
Court’s methodology in Auffmordt and Germaine. In those cases, the Court did
not evaluate a nonexistent office of the customs appraiser or office of the civil
surgeon. Instead, it evaluated the role of the individual customs appraiser and
the civil surgeon at issue in those respective cases. Auffmordt, 137 U.S. at 327;
Germaine, 99 U.S. at 512.
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IV. Conclusion
The qui tam provisions of the FCA do not violate the
Appointments Clause. Accordingly, we vacate the district court’s
order dismissing this case and remand for the district court to
evaluate the defendants’ Take Care Clause and Vesting Clause
arguments.
VACATED AND REMANDED.