Not every State has a State False Claims Act. The states that do have Acts are modeled after the federal False Claims Act. State Acts contain the same qui tam provisions contained in the federal FCA. The main similarities include:
- filing procedure;
- seal provisions;
- requirements regarding knowledge;
- materiality standard;
- most (but not all) exempt tax claims; and
- requirements regarding submission of false claims.
Some States have False Claims Acts that are “Medicaid-only” Statutes. Under these State Qui Tam statutes, individuals can only file cases when Medicaid is being defrauded. In comparison, under the federal FCA any fraud claim for money to the government can be reported and pursued. For example, false claims submitted to obtain government contracts can be pursued. Or false claims submitted to the Department of Defense in connection with a defense contract can be pursued.
Some other state provisions vary as well. States have different reward limitations. Meaning some states give whistleblowers higher percentages. Other states give whistleblowers lower percentages.
The damages per claim can vary amount states. A lot of States follow the $5,500-$1,000 per false claims submitted, but others go lower than that.
For information on the State Qui Tam Statutes, click on the state below. These links will lead you to separate pages describing the FCAs. It is here where you will be able to find the differences and similarities. Regardless of the State, it is important to find an experienced False Claims Act lawyer if you are considering filing a case.
ARKANSAS FALSE CLAIMS ACT
The Arkansas False Claims Act is codified at Arkansas Code § 20-77-901-911. The Arkansas Qui Tam Statute (“AFCA”) is modeled after the federal False Claims Act. There are many similarities. First, whistleblowers can file qui tam cases on behalf of the government. Second, the qui tam cases must related to government fraud. Third, the qui tam cases are investigated by the government. Fourth, if the qui tam case is successful, the whistleblower receives a reward. Fifth, under the Arkansas Qui Tam Statute the reward is a percentage of the recovery.
However, there are some differences that qui tam lawyers should be aware of. There are some significant differences between the Arkansas Qui Tam Statute and Federal False Claims Act. Similar to the Texas Qui Tam Statute, Colorado Qui Tam Statute, Washington Qui Tam Statute, Louisiana Qui Tam Statute, and Michigan Qui Tam Statute, the only fraud that can be pursued is fraud against the State’s Medicaid program. Additionally, the Arkansas Qui Tam Statute whistleblower award is limited. Explained further, the whistleblower will only receive up to 10% of the amount recovered by the State. However, under the Federal False Claims Act, the whistleblower receives 15-30% of the government recovery. Finally, the statute of limitations under the Arkansas Qui Tam Statute is 5 years. This is different than the statute of limitations for other False Claims Acts which is typically 6-10 years.
CALIFORNIA FALSE CLAIMS ACT
The California False Claims Act (“CFCA”) is codified at California Code, Government Code – GOV § 12650. In 1987, the California Qui Tam Statute was enacted. The law is modeled after the federal False Claims Act. The California Qui Tam Statute provides incentives to whistleblowers. Whistleblowers with information related to fraud, waste, and abuse being committed against the State of California to come forward. Details about this powerful statute are below.
California False Claims Act Statute
Any person who commits any of the following acts can be liable to the government under the California Qui Tam Statute:
- knowingly presents or causes to be presented a false or fraudulent claim for payment or approval;
- knowingly makes, uses, or causes to be made or used a false record or statement material to a false or fraudulent claim; or
- conspires to violate this subdivision
Key Difference in the California False Claims Act
Under the California Qui Tam Statute the qui tam plaintiff receives 15-33% of the proceeds of the action or settlement of the claim if the government intervenes (as opposed to 15-25% under the Federal False Claims Act). Additionally, the qui tam plaintiff receives 25-50% of the proceeds of the action or settlement of the claim if the government declines the case (as opposed to 25-30% under the Federal False Claims Act).
COLORADO FALSE CLAIMS ACT
The Colorado False Claims Act (“CMFCA”) is a powerful fraud fighting tool. The Colorado Qui Tam Statute went through a series of changes. The Act was repealed and expanded in 2010. The amendments allowed the Act to perform more like the federal False Claims Act. The legislators reformed the Colorado Qui Tam Statute to increase revenue for the State of Colorado.
Operation of the Colorado False Claims Act
Similar to the Federal False Claims Act, the Colorado Qui Tam Statute allows whistleblowers to stand in the shoes of the State of Colorado. While standing in Colorado’s shoes, the whistleblower can bring a qui tam action. If the whistleblower’s case is successful, he/she will receive a portion of the recovery. The percentage of the recovery varies depending upon the information the whistleblower provides. The reward will also vary depending on how much the whistleblower attorney assisted.
The Colorado Qui Tam Statute is different than the federal False Claims Act. The main difference between the two laws is that under the Colorado False Claims Act a qui tam lawsuit can only be filed if the fraud relates to Medicaid funds. Similarly, the Washington Qui Tam Statute, Arkansas Qui Tam Statute and Texas Qui Tam Statute only allow qui tam suits to be brought if they are related to healthcare.
CONNECTICUT FALSE CLAIMS ACT
The Connecticut False Claims Act, like the Federal False Claims Act, has qui tam provisions. Explained further, the qui tam provisions allow whistleblowers to bring an action on behalf of the government. Second, the qui tam provisions provides for whistleblower incentives. Third, the incentive is a financial reward if the case is successful. Fourth, under the Connecticut Qui Tam Statute, the reward is 15-30% of the government recovery.
For information on how the Connecticut False Claims Act operates, please refer to Whistleblower Information.
Differences in the Connecticut False Claims Act
Whistleblowers need to be aware of two main differences between the federal False Claims Act and Connecticut Qui Tam Statute.
The first difference relates to what type of fraud can be pursued. Under the Connecticut False Claims Act, an individual can only bring a qui tam case when a defendant submits false claims to the State’s Medicaid Program. Similarly, the Texas Qui Tam Statute, Colorado Qui Tam Statute, and Arkansas Qui Tam Statute, only allows individuals to bring qui tam cases when false claims are submitted to the respective State’s medical assistance program.
The second difference is related to tax fraud. The Federal False Claims Act specifically exempts qui tams based on tax fraud. However, the Connecticut Qui Tam Statute does not explicitly exempt false tax claims. Thus, it is potentially possible to bring a qui tam case under the Connecticut False Claims Act for tax fraud. Similarly, the New York Qui Tam Statute and Illinois Qui Tam Statute, allows whistleblowers to bring tax fraud claims.
DELAWARE FALSE CLAIMS ACT
The Delaware False Claims Act is entitled: “Delaware False Claims And Reporting Act.” The law is codified at 31 U.S.C. §§ 3729-3733.
The Delaware Qui Tam Statute is similar to the Federal False Claims Act in the following ways. First, the Delaware False Claims Act allows individuals with knowledge of fraud, waste, and abuse to bring a qui tam lawsuit. Second, the Delaware law requires fraud be committed against Delaware government funds. Third, the qui tam whistleblower reporting healthcare fraud under the Delaware Qui Tam Statute will stand to receive a reward if the case is successful. Fourth, the amount of the reward is 15-30% of the government recovery.
Delaware Attorney General Office
The Delaware Attorney General’s office has an Affirmative Litigation Unit. This unit is tasked with initiating qui tam lawsuits. In addition, the office is tasked with assisting with qui tam lawsuits brought under the Delaware False Claims Act. Typically, the office will schedule an interview with the whistleblower to obtain factual information regarding the case and the individual.
AG Office and Delaware Qui Tam Statute
The Delaware Attorney General’s office has a “Medicaid Fraud Unit.” This unit is used to investigate and prosecute illegal acts related to Medicaid funds. Including, qui tam cases brought under the Delaware Qui Tam Statute.
Furthermore, the Medicaid Fraud Unit, among other things, combats fraud by a Medicaid provider, such as: upcoding, phantom billing, unnecessary services, double billing, and kickbacks. All of these frauds can be brought under the Delaware Qui Tam Statute.
DISTRICT OF COLUMBIA FALSE CLAIMS ACT
The District of Columbia False Claims Act (“DCFCA”) is similar to the federal False Claims Act. First, the District of Columbia Qui Tam Statute allows individuals with knowledge of fraud to bring a qui tam action. Second, the government investigates the action with the assistance of investigators. Third, if the qui tam case recovers money, the whistleblower receives a reward. Fourth, the amount of the reward ranges between 15-30% of the recovery.
District of Columbia False Claims Act
Like the Federal False Claims Act, the District of Columbia Qui Tam Statute holds any person who presents false claims or records, or causes false claims or records to be presented to the government for payment liable.
If the person or entity is found to have violated the District of Columbia False Claims Act then he/she may be liable for a civil penalty. The penalty is from $5,000-$10,000 for each false claim.
Additionally, similar to the Utah Qui Tam Statute, Indiana Qui Tam Statute and Florida Qui Tam Statute, the District of Columbia Qui Tam Statue is not limited to Medicaid-only false claims. All types of fraud can be pursued under the District of Columbia False Claims Act.
District of Columbia False Claims Act Rewards
Also like the federal False Claims Act, there are incentives for whistleblowers to bring qui tam actions under the District of Columbia Qui Tam Statute. The incentive is the ability to receive a reward if the qui tam case is successful. The reward can range from 15-30% of the total amount recovered by the District of Columbia.
FLORIDA FALSE CLAIMS ACT
The Florida False Claims Act (“FFCA”) was enacted in 1994 and has been utilized in rooting out healthcare fraud ever since. The FFCA is modeled after the federal False Claims Act. Like the federal False Claims Act, the FFCA has qui tam provisions. The qui tam provisions allow individuals to file cases on behalf of the government and receive a portion of the award if the case is successful.
Florida False Claims Act
The Florida False Claims Act is codified at Fla. Stat. Ann. §§ 68.081-092. The Act states that an individual who knowingly presents or causes to be presented a false or fraudulent claim for payment or approval; makes, uses, or causes to be made or used a false record or statement material to a false or fraudulent claim; and/or conspires to do the above, is liable to the State of Florida for a civil penalty of not less than $5,500 and not more than $11,000 per claim, trebled.
If the State of Florida recovers money as a result of a case filed under the Florida False Claims Act, under the qui tam provisions the whistleblower is entitled to 15-25% or 25-35% dependent upon whether the government intervenes or not.
Key Differences in the Florida FCA
Under Fla. Stat. Ann. § 68.083(2), qui tam actions cannot be brought by attorneys for the state government, government employees when the actions are based on the information they obtained in the course of their employment, or persons who obtained their information from government employees “who [were] not acting in the course or scope of government employment.”
GEORGIA FALSE CLAIMS ACT
Georgia enacted a Georgia Taxpayer Protection False Claims Act (“GFCA”). This Georgia Qui Tam Statute contains many of the provisions of the Federal False Claims Act. More specifically, the Georgia False Claims Act allows for whistleblowers with knowledge of fraud, waste or abuse being committed against the government to file a qui tam suit. Explained further, if the qui tam suit is successful, the whistleblower will receive a monetary award. If you hire a successful qui tam attorney, they can walk you through the qui tam process.
Georgia False Claims Act
The Georgia Qui Tam Statute has changed over the years. The earlier version of the Georgia False Claims Act restricted qui tam suits to report Medicaid fraud only. Similarly, the Texas Qui Tam Statute, Washington Qui Tam Statute, Colorado Qui Tam Statute and Arkansas Qui Tam Statute only allow whistleblowers to file qui tam complaints related to healthcare fraud. Thus, whistleblowers cannot pursue fraud in any other industry. For example, a whistleblower who knew of a third party who defrauded the government in a bid for a construction project could not bring a qui tam suit.
In 2012, the State expanded the Georgia Qui Tam Statute. Under the new version of the Georgia False Claims Act, the government has authority to recover monetary damages and penalties from people or entities who present false claims to the government in any sector. Explained further, this includes false claims related to healthcare and otherwise.
This action made the law similar to the Hawaii Qui Tam Statute, Nevada Qui Tam Statute, and Massachusetts Qui Tam Statute. All of these laws do not restrict whistleblowers to just healthcare qui tams.
HAWAII FALSE CLAIMS ACT
The Hawaii enacted a False Claims Act (“HFCA”) modeled after the Federal False Claims Act. The purpose of the Hawaii Qui Tam Statute is to help fight fraud on State government programs. Like the Federal False Claims Act, the HFCA provides incentives for whistleblowers to file qui tam cases. Also, the Hawaii Qui Tam Statute allows individuals to report government fraud, including contracting and healthcare fraud. Most importantly, the incentive is a financial reward of 15-30% if the qui tam case is successful.
Key Provisions of Hawaiian False Claims Act
There are several key provisions of the Hawaii False Claims Act. First, the following actions constitute false claims violations:
submitting (or causing to be submitted) a false claim to the government for payment or approval;
making or using (or causing to) a false record or statement to get a false claim paid or approved;
conspiring to get a false claim allowed or paid;
delivering (or causing to be delivered) less property than the amount of the receipt,where the person with possession or control of the state or county money or property intends to deceive the agency or conceal the property;
making or delivering a receipt without knowing that it is true, where the person authorized to make or deliver the receipt intends to defraud the state or county;
buying or receiving (as a pledge of an obligation or debt) public property from an officer or employee of the state or county who has no legal right to sell or pledge the property;
knowingly making or using a false record to conceal, avoid, or decrease an obligation to pay money or transmit property to the state or county;
or benefiting from an inadvertent submission of a false claim, subsequently discovering the falsity of the claim, and failing to disclose to the state or county within a reasonable time after discovery.
Additionally, the Hawaii Qui Tam Statute allows a court may reduce the damages if the person committing the violation voluntarily disclosed all information known to him or her within thirty days of obtaining the information.
Similar to the Hawaii False Claims Act, the following State False Claims Acts have these provisions as well: Michigan Qui Tam Statute, New Hampshire Qui Tam Statute, and North Carolina Qui Tam Statute.
Hawaii Fights Government Fraud
In addition to the Hawaii Qui Tam Statute, Hawaii has also enacted a separate law applying false claims to counties. Haw. Rev. Stat. §§ 46-171 to 46-179.
The county false claims law is virtually identical to that of the state false claims law. However, its provisions reflect the fact that the government is a county.
ILLINOIS FALSE CLAIMS ACT
The Illinois False Claims Act is an anti-fraud statute and is modeled after the Federal False Claims Act. Lawsuits under the Illinois Qui Tam Statute may be brought by the state or an individual under the qui tam provisions. In the former situation, the whistleblower is called the “relator.” The relator is entitled to a percentage of the proceeds or settlement if the case is successful.
Differences in the Illinois False Claims Act
The Illinois Qui Tam Statute and Federal False Claims Act are very similar. They also function almost identically. However, there are some meaningful differences between the two.
First, and the most important difference is that under the Federal False Claims Act whistleblowers cannot bring a qui tam case to report tax fraud. However, under the Illinois False Claims Act (like the New York Qui Tam Statute), cases for tax fraud against the State are not exempt. For details, a successful qui tam attorney can walk you through this distinction.
Illinois Medicaid Fraud
There have been many settlements under the Illinois Qui Tam Statute. In fact, there was a qui tam settlement against Illinois doctor Manuela Farhi. Explained further, Dr. Farhi was charged with Medicaid fraud under the Illinois False Claims Act. More specifically, the doctor cheated the Illinois government out of $100,000 in Medicaid money. This means he was paid $100,000 more dollars by the government than he was owed. The doctor was billing for services allegedly provided to OB/GYN patients that she was not actually providing. The case was investigated by Illinois State Police Medicaid Fraud Control Bureau.
INDIANA FALSE CLAIMS ACT
The Indiana False Claims Act (“IFCA”) was enacted to fight fraud committed against the State. The Indiana Qui Tam Statute is similar to the Federal False Claims Act in many ways.
First, a whistleblower can file a qui tam suit to report fraud against the government.
Second, the whistleblower may be entitled to 10-30% of the monetary damages the company pays. Additionally, the monetary damages can amount to millions of dollars. For example, there have been large qui tam settlements against banks, pharmaceutical companies, and in other industries. Under all these settlements, the whistleblower received millions of dollars.
Indiana Medicaid Fraud Unit
The Indiana government stated that fraud in the health care costs taxpayers millions of dollars each year. Additionally, the fraud mostly related to pharmaceutical companies submitting false claims to the Medicaid program. The government recommended that whistleblowers seeking to report Medicaid or report government fraud should contact a private attorney ,the best qui tam attorney is up to opinion. After finding an attorney the whistleblower should file a case under the Indiana Qui Tam Statute.
Differences in the Indiana False Claims Act
The Indiana Qui Tam Statute and the Federal False Claims act are very similar. This is not a surprise: the Indiana Qui Tam Statute is not Medicaid-only. This means that all types of fraud can be pursued under the Act. This is similar to Acts that other States have enacted. For example, the Massachusetts Qui Tam Statute, Virginia Qui Tam Statute, and Connecticut Qui Tam Statute.
However, there are some differences between the two False Claims Acts. Two important differences between the Indiana False Claims Act and Federal False Claims Act are:
First, under the IFCA, a qui tam lawsuit cannot be brought by a State current or former employee whistleblower unless he/she reports the fraud internally and the state failed to act. There are no prohibitions similar to this under the Federal FCA.
Second, the Federal False Claims Act allows Courts to, at their discretion, reduce the amount a whistleblower can receive after being successful in a qui tam action if he/she participated in the violation. The IFCA complete bars whistleblowers who participated in the conduct from receiving a whistleblower award.
IOWA FALSE CLAIMS ACT
The Iowa False Claims Act (“IFCA”) mirrors the Federal False Claims Act. The two Acts share these key provisions:
individual or whistleblower can bring a qui tam case on behalf of the government;
the qui tam case is filed under seal and investigated by the government;
after the government completes its investigation, it makes an intervention decision
after the intervention decision the qui tam case comes out from under seal;
if the qui tam case is successful, the whistleblower will receive a portion of the proceeds as a reward; and
the portion of the reward ranges between 15-30% of the recovery.
In sum, the Iowa Qui Tam Statute is very similar to the federal False Claims Act. Additionally, the fraud is not limited to only healthcare fraud. Whistleblowers can seek to recover money in all industries. They can pursue rewards for reporting all types of government fraud.
Iowa False Claims Act Settlements
The Iowa Attorney General filed a civil lawsuit against the owners of two Keokuk care facilities. The lawsuit alleges money laundering. The lawsuit also alleges that the defendant submitted false or fraudulent Medicaid claims. The second claim was brought under the Iowa Qui Tam Statute.
More specifically, the complaint alleges that the defendants submitted improper expenses. These improper expenses were submitted to the Iowa Medicaid program. The expenses included airline and train travel, hotel rooms, payments for an employee’s camper, and various fraudulent financial transactions and unallowable expenses. This is a clear violation of the Iowa Qui Tam Statute.
As a result, Iowa sought over $17 million under false claims civil law enforcement action and a state money laundering statute.
LOUISIANA FALSE CLAIMS ACT
Louisiana enacted a False Claims Act modeled after the Federal False Claims Act. The Louisiana Qui Tam Statute is entitled: Louisiana Medical Assistance Programs Integrity Law (“LFCA”). The Louisiana Act is one of the premiere fraud fighting tools available to taxpayers and the government. In fact, the more the tool is utilized the better off we are as a country and the more taxpayers dollars are saved.
One of the stated purposes of the LFCA is to recover state government funds. Explained further, the Louisiana False Claims Act was enacted because the federal False Claims Act does not cover fraud occurring in state specific contracts, or funds. Thus, the Louisiana False Claims Act fills in that hole. Indeed, like Louisiana other states have enacted State-specific False Claims Acts, such as the: North Carolina Qui Tam Statute, Michigan Qui Tam Statute, Illinois Qui Tam Statute, and New Mexico Qui Tam Statute.
Louisiana False Claims Act
The Louisiana False Claims Act is like the federal False Claims Act. The two Acts share similar unique provisions. Both Acts contain the following provisions:
First, both False Claims Acts allow whistleblowers to bring qui tam cases on behalf of the government;
Second, the qui tam must contain allegations for fraud on the government;
Third, if the government recovers money from the qui tam case, the whistleblower receives a portion of the recovery; and
Fourth, the portion of the recovery ranges between 15-30%.
The Louisiana False Claims Act has many unique characteristics. Thus, it is important to reach out to the best qui tam lawyer for the person seeking to file. Once a whistleblower finds a lawyer, prior to filing a case, they should examine the pros and cons of filing a whistleblower case.
MARYLAND FALSE CLAIMS ACT
The Maryland False Claims Act (“MFCA”) is similar to the federal False Claims Act. The two Acts are similar in the following ways. First, individual whistleblowers can bring qui tam cases on behalf of the State.
Second, if the qui tam case is successful the whistleblower may receive a percentage of the money the government recovered. Third, the percentage of the recovery the whistleblower receives is in between 15-30%.
There have been many successful cases brought using the Maryland Qui Tam Statute.
Report Government Fraud
The Maryland Qui Tam Statute and federal False Claims Act have similar provisions. However, all of the provisions are not the same as other State False Claims Act. For example, the Maryland False Claims Act differs from False Claims Act that limit the types of false claims a whistleblower could pursue to healthcare. Rather, Maryland allows a whistleblower to pursue all types of government fraud. In sum, the Maryland False Claims Act is not like the False Claims Act enacted by Texas False Claims Act, Colorado False Claims Act or Arkansas False Claims Act, in that all types of government fraud can be pursued.
Maryland False Claims Act Settlement
The Maryland Attorney General had announced a settlement with Walgreens. More specifically, a whistleblower filed a case under the federal False Claims Act and Maryland Qui Tam Statute. The qui tam lawsuit alleged that Walgreens violated the False Claims Act by billing Medicaid at a higher rate than its usual and customary (U&C) rates. This is healthcare fraud and is illegal. Maryland joined the federal government and other states in reaching a $60 million settlement with Walgreens. This settlement involved Walgreens’ Prescription Savings Club discount drug program. The Maryland Medicaid program received $131,675.76 in this settlement.
MASSACHUSETTS FALSE CLAIMS ACT
Massachusetts enacted a False Claims Act modeled after the Federal False Claims Act (“MFCA”). The Massachusetts Qui Tam Statute is a powerful tool to combat fraud, waste, and abuse. This fraud, waste and abuse must be committed against State government programs. The MFCA, like the Federal False Claims Act, allows individuals to bring a qui tam suit on behalf of the government. Additionally, the whistleblower receives a percentage of the proceeds when the government recovers money.
Massachusetts, like the Puerto Rico Qui Tam Statute, Vermont Qui Tam Statute, and Indiana Qui Tam Statute, enacted a False Claims Act that was not limited to abuse of Medicaid funds. Thus, all types of government fraud can be pursued under the Massachusetts Qui Tam Statute.
Massachusetts False Claims Division
In 2015, the Massachusetts Attorney General created the “Massachusetts False Claims Division.” More specifically, this False Claims Divisions works to safeguard public funds through proactive outreach and prosecution of government fraud. One of the main tools used by the False Claims Division to fight fraud is the Massachusetts Qui Tam Statute. This Act is one of the fiercest fraud fighting tools around. Fraudsters must beware!
Massachusetts False Claims Act Success
The Massachusetts Attorney General reported recovering hundreds of millions of dollars in government funds. These government funds are related to healthcare fraud. The reported number includes qui tam actions brought by whistleblowers under the Massachusetts Qui Tam Statute. The Massachusetts Attorney General stated it will “continue to partner with whistleblowers” to expand on those successes outside the MassHealth context. In other words, the Attorney General is interested in pursuing healthcare fraud under the Massachusetts Qui Tam Statute. Whistleblowers should seek the best qui tam attorney to partner with the government.
MICHIGAN FALSE CLAIMS ACT
In 2006, Michigan enacted the Michigan False Claims Act (“MFCA”). The Michigan Qui Tam Statute is similar to, but not exactly like, the Federal False Claims Act. The MFCA and the federal FCA have the following similarities. First, both of the Acts provide opportunities for whistleblowers who seek to report fraud against the government to file a qui tam lawsuit. Second, there are similar ways to file a qui tam lawsuit. More specifically, a qui tam statute needs to be filed under seal and served on the government in a certain way. Third, if the qui tam lawsuit is successful the whistleblowers receive a monetary award. Finally, the financial award varies depending on certain factors but typically is 15-30% of the total recovery.
Report Medicaid Fraud
However, the Michigan False Claims Act is different than the Federal False Claims Act. Explained further, the Michigan Qui Tam Statute is different than the Federal False Claims Act because whistleblowers can only file qui tam cases to report Medicaid fraud.
Thus, the Michigan False Claims Act is similar to the Texas Qui Tam Statute, Arkansas Qui Tam Statute, Connecticut Qui Tam Statute, and the Colorado Qui Tam Statute. All of these aforementioned Acts focuses strictly on reporting healthcare fraud. If a whistleblower seeks to report fraud in other industries, he/she cannot file under the Michigan Qui Tam Statute. For example, if the whistleblower knows of government contracting fraud or defense contracting fraud, he/she could not file under the Michigan False Claims Act.
Michigan Qui Tam Statute and Healthcare Fraud
That said, there are many different types of healthcare fraud that can be reported using the Michigan Qui Tam Statute and other False Claims Acts. For example, false claims involving upcoding, claims that providers are billing for services not provided, claims that are tainted by kickbacks, and off-label marketing claims can all be reported.
MINNESOTA FALSE CLAIMS ACT
The Minnesota False Claims Act is similar to the Federal False Claims Actin the following ways. First, the Minnesota Qui Tam Statute allows whistleblowers to file qui tam lawsuits to report government fraud. For example, the fraud can be related to billing, violations of regulations, or medical necessity, such as fraudulent ambulance trips billed to Medicare.
Second, as a reward for reporting fraud, the whistleblower receives a portion of the recovery if the case is successful. Explained further, the Montana Qui Tam Statute allows the whistleblower to recover 15-30% of the government recovery.
Minnesota False Claims Act Background
The background of the Minnesota Qui Tam Statute is not complicated. The Act was supported by Minnesota Senator Simon. Taxpayers were urged to support the MFCA because it allowed:
Whistleblower employees to bring false claims directly on behalf of the state government (i.e., a qui tam case).
Whistleblowers who uncover fraud to receive a percentage of the recovery (speak to the best qui tam lawyer for you to determine potential amounts).
The State of Minnesota to receive millions in taxpayer money lost through fraud.
Government fraud to be deterred.
The ability to raise State revenues without raising taxes or cutting vital investments.
For more information, you can view examples of qui tam rewards given in Florida and California.
In sum, it is important to note that most cases are filed under the federal False Claims Act. However, whistleblowers can also allege violations of the Montana Qui Tam Statue. This is because both the State and the Federal government are getting defrauded by the same conduct. Thus, when a whistleblower reports government fraud it will pay off to include both, or rather, all State False Claims Acts.
MONTANA FALSE CLAIMS ACT
The Montana False Claims Act is similar to the federal False Claims Act. First, individuals with knowledge of government fraud can file a qui tam suit on behalf of the state. Second, the whistleblower receives a portion of the government proceeds for filing a successful qui tam suit.
That said, in order to proceed under the Montana Qui Tam Statute, it is important to obtain a good qui tam attorney. If you don’t have a good one, you should obtain a referral for a qui tam attorney. In sum, you need a good qui tam attorney because there are consequences to filing a False Claims Act case. Additionally, there is a complicated filing procedure, that requires experience.
Montana False Claims Act Settlements
The following is an example of a case settled under the Montana Qui Tam State. Here, a group of Montana Hospitals agreed to pay $3.95 Million to resolve alleged False Claims Act violations. More specifically, the whistleblower alleged that the hospitals violated the Stark Law.
Explained further, the settlement resolves allegations that the hospitals paid several physicians incentive compensation. Furthermore, the incentive compensation took into account the value or volume of physician referrals. The referrals included certain designated health services in the formula when calculating physician salary.
However, while this was a case under the Montana False Claims Act, there was no qui tam suit filed. Rather, these issues were disclosed by the hospitals to the government. If a company self-discloses a violation it will not have to pay as much in damages. Thus, as a healthcare company it is good to report government fraud as soon as it is discovered.
NEVADA FALSE CLAIMS ACT
The Nevada False Claims Act (“NFCA”) is modeled after the Federal False Claims Act and have in common the following provisions. First, individuals or whistleblowers who seek to report government fraud can file a qui tam case on behalf of the State. Second, the qui tam complaint must be filed under seal and it remains under seal until the government completes its investigation. Third, the whistleblower receives a financial reward when the qui tam case recovers money. Explained further, the amount of money the whistleblower receives is 15-30% of the recovery. Thus, the Nevada Qui Tam Statute can be lucrative for individuals seeking to report fraud.
Nevada False Claims Act Liability
Damages under the Nevada Qui Tam Statute are substantial. Explained further, defendant must pay:
between a $5,500 and $11,000 civil penalty per false claim submitted;
three times the amount of damages sustained by the State or political subdivision; and
the costs of the civil action, including filing fees, travel and attorney’s fees.
The Nevada Qui Tam Statute is similar to the following laws: Iowa Qui Tam Statute, Florida Qui Tam Statute, Puerto Rico Qui Tam Statute, and New York Qui Tam Statute. Under all of these Acts, all types of government fraud can be pursued.
Nevada False Claims Act Settlement
The following is an example of a settlement under the Nevada Qui Tam Statute. Cardiovascular And Thoracic Surgeons Of Nevada Inc. agreed to pay $1.5 Million to settle False Claims Act allegations. In sum, this settlement resolves allegations that, from January 1, 2006 through May 31, 2011, defendants billed federal healthcare programs for surgical services not provided. Additionally, the defendant billed for more expensive surgical evaluation and management services than those actually provided to patients.
NEW HAMPSHIRE FALSE CLAIMS ACT
The New Hampshire False Claims Act (“NHFCA”), like other state False Claims Acts, is modeled after the Federal False Claims Act. First, the New Hampshire Qui Tam Statute provides incentives for whistleblowers to bring qui tam suits. Second, the qui tam suits allow individuals to report government fraud. This includes such fraud as contracting fraud, healthcare fraud,and billing fraud. Third, if the qui tam suit is successful, the whistleblower will receive a portion of the recovery. However, it is important to speak to a successful qui tam attorney regarding the qui tam process.
Essentials to the New Hampshire False Claims Act
The New Hampshire Qui Tam Statute does the following:
First, it establishes liability to the state for fraud claims with respect to Medicaid spending;
Second, the Act has provisions that are effective in rewarding whistleblowers for bringing successful qui tam cases;
Third, the New Hampshire Qui Tam Statute contains a seal requirement; and
Finally, the New Hampshire False claims Act provides for a civil penalty if the qui tam case is successful.
Differences in the New Hampshire Qui Tam Statute
The most important difference between the New Hampshire False Claims Act and the federal False Claims Act is the type of fraud that can be pursued. For example, under the NHFCA only healthcare fraud can be pursued.
Thus, whistleblowers cannot pursue other types of fraud against New Hampshire under this Law. This is similar to other State Medicaid-only False Claims Acts, such as: Washington Qui Tam Statute, Colorado Qui Tam Statute, Arkansas Qui Tam Statute, Maryland Qui Tam Statute, and the Connecticut Qui Tam Statute.
NEW JERSEY FALSE CLAIMS ACT
Using the Federal False Claims Act as the standard, New Jersey adopted its own law, The New Jersey False Claims Act (“NJFCA”). Like the Federal FCA, under the New Jersey Qui Tam Statute, whistleblowers file qui tam lawsuits. Similarly, if the qui tam lawsuit recovers money, the whistleblower receives a financial reward. Therefore, it is important to note the types of qui tam cases that have been successful. The examples of successful False Claims Act cases vary. These cases include cases that have involved violations of specific regulations and billing violations.
New Jersey Qui Tam Statute Success
In 2012, the New Jersey Attorney General reported to the State Legislature that New Jersey recovered approximately $20 million in damages and $16 million in penalties via New Jersey False Claims Act settlements. Furthermore, there were 183 qui tam suits brought by private individuals. All of the qui tam suits brought reported Medicaid fraud. That said, the NJFCA is not a “Medicaid-only” statute. This means that like under the Rhode Island Qui Tam Statute, Utah Qui Tam Statute, and Montana Qui Tam Statute, a whistleblower can pursue all types of government fraud. In other words, the whistleblower is not limited to reporting healthcare fraud.
New Jersey False Claims Act Settlements
There have been many successful qui tam cases brought under the New Jersey False Claims Act. For example, in May 2018 the New Jersey Attorney General announced a settlement against a construction company brought under the New Jersey Qui Tam Statute. In sum, the settlement resolved allegations that the company committed multiple False Claims Act violations by contracting for public construction jobs while paying its workers a lower hourly wage than required by law. The whistleblower who filed the successful suit under the New Jersey Qui Tam Statute was a former employee of the defendant. In conclusion, the case settled for $1.5 million and $499,000 went to the State of New Jersey.
NEW MEXICO FALSE CLAIMS ACT
The State of New Mexico enacted a New Mexico Medicaid False Claims Act (“NMFCA”). The stated purpose of the New Mexico Qui Tam Statute is: “to deter persons from causing or assisting to cause the state to pay medicaid claims that are false.” The second purpose of the Act is “to provide remedies for obtaining treble damages and civil recoveries for the state when money is obtained from the state by reason of a false claim.”
New Mexico Qui Tam Statute Differences
Like the Federal False Claims Act, the New Mexico False Claims Act allows whistleblowers or individuals with knowledge to file qui tam cases. The filing of the qui tam case is to report government fraud. If the qui tam is successful the qui tam whistleblower will receive a portion of the proceeds. The amount of proceeds under the New Mexico Qui Tam Statute is between 15-30% of the recovery.
However, under the NMFCA, a qui tam plaintiff can only file a qui tam case to recover damages for false claims submitted to Medicaid. This type of False Claims Act, is similar to the following: Texas Qui Tam Statute, Arkansas Qui Tam Statute, and Colorado Qui Tam Statute. Under all of these False Claims Acts, only healthcare fraud can be pursued. To that end, there have been successful qui tam cases involve healthcare qui tams. These successful healthcare qui tams include cases against pharmaceutical companies, dialysis companies, and others.
Immunity under the New Mexico False Claims Act
One interesting clause in the New Mexico Qui Tam Statute is the provision on immunity. This clause is interesting because the provision states that: “Notwithstanding any other law, a person is not civilly or criminally liable for providing access to documentary material pursuant to the Medicaid False Claims Act [27-14-1 NMSA 1978] to a person identified in Subsection B of Section 5 of that act.” See NM Stat § 27-14-6 (2013). In sum, if this immunity is confusing you should consult a successful qui tam lawyer.
NEW YORK FALSE CLAIMS ACT
The New York Qui Tam Statute, like the other State False Claims Acts, is modeled after the Federal False Claims Act. To that end, the New York State False Claims Act (“NYFCA”) encourages and provides incentives for private citizens to bring a qui tam lawsuit on behalf of the State government. The incentive to bring the case is the key to the NYFCA. That is, the whistleblower or relator will receive a financial reward for a successful qui tam suit. The range of the qui tam reward is 15-30% of the amount recovered. While there is a large incentive, the decision to bring a qui tam case should be examined with an experienced qui tam lawyer.
New York Qui Tam Statute and Government Fraud
The NYFCA applies to fraud of any kind made to any portion of the government. The New York Qui Tam Statute applies to any request or demand made to the government, under contract or otherwise. In sum, a whistleblower can bring a qui tam lawsuit to report fraud in the healthcare industry, defense contracting, government contracting or any industry involving government funding.
To get an idea of the types of qui tam cases that can be brought, it might be helpful to view different types of successful qui tam cases. These successful qui tam cases are broken down by industry, including against banks, against medical device companies, and against pharmacies.
Differences in the New York False Claims Act
Many of the other state False Claims Acts (i.e., Washington False Claims Act, Michigan False Claims Act, New Hampshire False Claims Act, etc.), and the Federal False Claims Act, do not allow whistleblowers to bring qui tam claims alleging tax fraud. However, the New York Qui Tam Statute allows qui tam tax fraud cases. In fact, the State of New York has settled some tax fraud cases brought under the NYFCA.
The New York Attorney General announced that it settled a qui tam case against Sprint for $330 million. The lawsuit brought under the New York Qui Tam Statute –People v. Sprint Communications, Inc. et al., Index No. 103917/2011 (New York County Supreme Court) – alleged that Sprint failed to collect and remit more than $100 million in state and local sales taxes. These taxes were owed on its flat-rate wireless calling plans sold to New Yorkers.
New York False Claims Act Settlements
In addition to the Sprint Tax Fraud Settlement, New York State has been successful in other False Claims Act cases. On January 22, 2019 the New York State Attorney General announced a settlement in principle with Walgreens. The settlement was over false claims billed to the Medicaid program. The $8 million dollar False Claims Act settlement resolves claims that Walgreens violated the New York Qui Tam Statute by billing Medicaid at rates higher than its usual and customary (U&C) rates for certain prescription drugs.
NORTH CAROLINA FALSE CLAIMS ACT
The North Carolina False Claims Act is modeled after the Federal False Claims Act. The purpose of the North Carolina Qui Tam Statute is “to deter persons from knowingly causing or assisting in causing the State to pay claims that are false or fraudulent.” The second purpose of the NCFCA is “to provide remedies in the form of treble damages and civil penalties when money is obtained from the State by reason of a false or fraudulent claim.”
Operation of the North Carolina False Claims Act
The North Carolina Qui Tam Statute operates like the Federal False Claims Act. It is important to contact a successful qui tam lawyer to discuss the details. However, we will provide the basic outline below:
whistleblower with knowledge of government fraud (knowledge can be documentary or testimonial);
if the whistleblower seeks to report government fraud, he/she can file a qui tam case on behalf of the government;
the qui tam case is filed and remains under seal until the government completes its investigation;
government completes the investigation and makes an intervention decision; and
if the filing under the North Carolina Qui Tam Statute is successful the whistleblower may receive 15-30% of the proceeds.
North Carolina Qui Tam Statute Settlement
A False Claims Act case filed in North Carolina settled for $29.8 million. The $29.8 million resolved claims that, from 2008 to 2012, defendant EmCare received payment from non-defunct Health Management Associates (HMA). the payment increased Medicare admissions at HMA Hospitals by recommending admission for patients whose medical care should have been billed as outpatient or observation services. This is another example of a successful qui tam case against hospitals or medical centers for improper billing.
OKLAHOMA FALSE CLAIMS ACT
The Oklahoma False Claims Act is a general False Claims Act. In other words, the law is not limited to Medicaid or healthcare false claims. This general qui tam statute is similar to the: Florida False Claims Act, Virginia False Claims Act, Iowa False Claims Act, and Nevada False Claims Act.
The Oklahoma False Claims Act or “OFCA” is similar to the Federal False Claims Act – whistleblowers can file qui tam suits to report fraud. If the lawsuit under the Oklahoma Qui Tam Statute is successful, the whistleblower may receive a portion of the recovery. If the qui tam case is successful, the amount of the reward would range between 15-30%
Settlement Under Oklahoma False Claims Act
Oklahoma Orthopedic Company and Physicians Agree to Pay $670,000 to Settle a case under the Oklahoma Qui Tam Statute. The qui tam complaint alleged the defendant submitted false claims to Medicare, Medicaid, and Tricare for unnecessary medical procedures. The medical procedures billed for involved ultrasonic guidance for needle placement imaging supervision and interpretation. Oklahoma will receive a portion of this total because of alleged false claims submitted to Medicaid. This settlement resolves two of the allegations filed in a lawsuit by a whistleblower who formerly worked for Southwest Orthopaedic. One of the cases was brought under the Oklahoma Qui Tam Statute.
PUERTO RICO FALSE CLAIMS ACT
The Puerto Rico False Claims Act (“PRFCA”) allows private persons that know of government fraud to file a qui tam case on behalf of the government.
The Puerto Rico Qui Tam Statute is modeled after the Federal False Claims Act, the provisions are mostly the same.
Similar to other False Claims Acts that are modeled after the federal FCA, the Puerto Rico False Claims Act allows individuals to bring claims in all industries. Other False Claims Acts limit the ability to file a qui tam case to only healthcare related fraud.
Puerto Rico False Claims Act Provisions
As stated above, the Puerto Rico Qui Tam Statute is similar to the federal FCA. To that end, the Act has the following similar provisions:
a whistleblower can file a qui tam case on behalf of the government; and
the Puerto Rico False Claims Act contains a reward provision. The reward provision compensates the private whistleblower, known as the relator, if the government recover fraudulently obtained government funds. the percentage of the reward varies. But the reward is typically between 15-30%.
Best to contact a successful qui tam lawyer for assistance with filing a case under the Puerto Rico False Claims Act.
Issues with Filing a Qui Tam Case Under the PRFCA
Filing a qui tam case can put the whistleblower at discomfort both personally and professionally. The consequences of filing a False Claims Act case are universal. These cons should be weighed against the pros; typically a large financial recovery. Individuals can be affected because the qui tam case could:
cause the whistleblower’s employer to retaliate and possibly get terminated;
harm the whistleblower’s reputation in the industry making it difficult to obtain future employment
face possible counterclaims for allegedly stealing documents or breaching confidentiality agreements;
and others.
RHODE ISLAND FALSE CLAIMS ACT
The State of Rhode Island enacted the Rhode Island False Claims Act or the “RIFCA”. The RIFCA is modeled after the Federal False Claims Act and shares the following provisions:
a whistleblower can file a qui tam claim on behalf of the state;
the whistleblower must file the qui tam claim under seal;
under the Rhode Island Qui Tam Statute the case remains sealed until the government completes its investigation; and
if the qui tam suit is successful and the government recovers money, the whistleblower receives 15-30% of the proceeds.
Rhode Island False Claims Act Settlement
There have been many settlements pursuant to the Rhode Island Qui Tam Statute. Most of the settlements involve cases which were filed under the federal False Claims Act and Rhode Island State False Claims Act.
For example, Rhode Island settled a False Claims Act case for $2.6 Million. The qui tam case alleged that defendants violated the False Claims Act through its knowing submission of three types of claims:
billing Medicare for percutaneous transluminal angioplasties (PTAs) that were medically unnecessary under Medicare guidance;
billing for more PTAs per patient encounter than permitted; and
billing for medically unnecessary procedures during follow-up visits.
The case was settled under the Federal FCA. Because the qui tam complaint added the Rhode Island Qui Tam Statute, Rhode Island received a potion of the Medicaid share. The case was captioned: United States ex rel. Souza v. American Access Care of Miami, LLC (S.D. Fla.). The whistleblower was represented by a qui tam attorney. Pursuant to the qui tam provisions of the Rhode Island False Claims Act, the whistleblower received a portion of the proceeds.
TENNESSEE FALSE CLAIMS ACT
The Tennessee False Claims Act is similar to the Federal False Claims Act. Under the Tennessee False Claims Act (“TFCA”), whistleblowers can file qui tam cases to report Medicaid fraud. If the qui tam case is successful the whistleblower, and the successful whistleblower attorney, may be entitled to a reward. Rewards under the Tennessee Qui Tam Statute can range from 15-30% of the proceeds recovered by the government.
Difference in the Tennessee False Claims Act
The main difference between the TFCA and the federal False Claims Act is that the TFCA only allows whistleblowers to bring qui tam cases to report Medicaid fraud. In this regard, the Tennessee False Claims Act is similar to the False Claims Acts of Texas False Claims Act, Arkansas False Claims Act, and Colorado False Claims Act.
Settlements Under the Tennessee False Claims Act
On January 24, 2018, the Department of Justice announced that a Tennessee chiropractor paid over $1.45 million to resolve allegations filed against the individual. The allegations were filed pursuant to the Tennessee Qui Tam Statute. The case – United States ex rel. Norris v. Anderson, No. 3:12-cv-00035 (M.D. Tenn.) – alleges that the defendants caused pharmacies to submit requests for Medicare and TennCare for payments for pain killers, including opioids, which had no legitimate medical purpose. The conduct was ongoing from 2011 to 2014. The government is very interested in excessive or improper opioid use. This is because of the amount of addiction that exists in the United States that results in death and harm. If there is a case containing allegations of improper prescriptions of opioids under the Tennessee Qui Tam Statute, the government will likely take a strong interest in the allegations.
TEXAS FALSE CLAIMS ACT
The State of Texas enacted the “Texas Medicaid Fraud Prevention Act” or the Texas False Claims Act (“TFCA”) in 1995. The TFCA is modeled after the federal False Claims Act and allows individuals who have knowledge of Medicaid fraud to file a qui tam case on behalf of the State of Texas. If the Texas qui tam case is successful, the whistleblower will receive a portion of the money awarded.
Differences in the Texas False Claims Act
Whistleblowers please be aware of the following differences between the Federal and the Texas False Claims Act:
The Texas False Claims Act targets only Medicaid fraud. Thus, whistleblowers cannot pursue other types of fraud against Texas under this Law. This is similar to other State Medicaid-only False Claims Acts, such as: Washington Qui Tam Statute, Colorado Qui Tam Statute, Arkansas Qui Tam Statute, and the Maryland Qui Tam Statute.
The Texas False Claims Act incentivizes whistleblowers to file because it allows for increased penalties: $5,500-$15,000 (rather than $5,000-$11,000).
The Texas False Claims Act does not require specific false claims like the federal False Claims Act. Instead, the Texas False Claims Act penalizes unlawful acts.
Settlements under the Texas False Claims Act
In August 2018, the Texas Attorney General announced that AstraZeneca agreed to pay $110 Million to the State of Texas to settle claims brought under the Texas False Claims Act. The State of Texas alleged that the company promoted its drugs, Seroquel and Crestor, off-label. Pharmaceutical companies are not allowed to market drugs for indications not approved by the FDA.
UTAH FALSE CLAIMS ACT
The Utah False Claims Act (“Utah”) has one significant differences from the Federal False Claims Act. This difference is that it focuses only on false claims submitted to its state run healthcare program. In this way, the Utah Qui Tam Statute is similar to the Texas False Claims Act, Arkansas False Claims Act, and other False Claims Acts that focus on Medicaid funds.
Liability Under Utah False Claims Act
In all other respects, the Utah Qui Tam Statute is similar to the Federal False Claims Act, in that:
whistleblowers seeking to report government fraud can file a qui tam case on behalf of the government;
qui tam case remains under seal until the government completes its investigation and makes an intervention decision; and
if the qui tam case is successful, the whistleblower may receive 15-30% of the proceeds.
A successful qui tam attorney should walk you through the process.
Utah False Claims Act Settlements
In April 2018, a construction company and daycare agreed to pay the federal government a combined amount of $1,062,900 and $150,000 respectively to resolve allegations that they violated the terms of a Small Business Administration (SBA) program for small and disadvantaged businesses. The government argued that the defendants failed to meet the SBA’s regulatory requirement that the small businesses perform a certain percentage of the work under the contracts, thereby causing the small businesses to submit false or fraudulent claims for payment to the United States. The settlements involve a number of different government contracts in Kansas, Colorado, New Mexico, and Utah between July 2009 and June 2013.
Utah-Based Lenders Agree to Pay Nearly $10 Million to Resolve Alleged False Claims Act Liability Arising from FHA-Insured Mortgage Lending. The two lenders, headquartered in Utah, knowingly originated and underwrote mortgage loans insured by the U.S. Department of Housing and Urban Development’s (HUD) Federal Housing Administration (FHA) that did not meet applicable requirements. This is one of many successful qui tam actions against banks.
VERMONT FALSE CLAIMS ACT
The Vermont False Claims Act allows whistleblowers to bring qui tam actions on behalf of the State of Vermont. The Vermont Qui Tam Statute, is like the Federal False Claims Act. Under both statutes a case is filed under seal and served on the government. After the government investigates the case it makes an intervention decision. Then the qui tam case comes out from under seal. If the qui tam case is successful, the whistleblower receives 15-30% of the government’s proceeds. A successful qui tam lawyer can walk you through the filing of a qui tam case.
Unique Provisions of the Vermont False Claims Act
The Vermont Qui Tam Statute differs in some ways from the Federal False Claims Act. For example, under the Vermont False Claims Act, the State may decide to proceed in an administrative proceeding in lieu of a civil suit. This is different than the federal False Claims Act.
Also, under the Vermont Qui Tam Statute, if a final judgment is reached in a criminal case and that criminal case charges the defendants with fraud of any kind. The defendant cannot deny the same conduct in a qui tam suit under the Vermont False Claims Act. The federal False Claims Act does not explicitly state this, like the Vermont Act.
Additionally, Vermont’s Act is similar to the Florida False Claims Act and Iowa False Claims Act. Under these Acts, fraud is not limited to healthcare or Medicaid fraud. Rather, fraud can be pursued against against all types of government funds.
VIRGINIA FALSE CLAIMS ACT
The Virginia False Claims Act (officially titled the “Virginia Fraud Against Taxpayers Act”) tracks the Federal False Claims Act. The purpose of the Virginia False Claims Act (“VFCA”) is to encourage whistleblowers to file qui tam cases. These cases assist the government to facilitate investigations of fraud.
Virginia Qui Tam Statute Procedures
Like the Federal False Claims Act, the VFCA allows whistleblowers to receive a portion of the money recovered by the State. The whistleblower receives an award only in successful qui tam cases. These incentives, or awards, amount to 15-30% of the total recovery. The amount of the reward depends on certain factors. Additionally, the VFCA has a clause that protects whistleblowers from retaliation.
Virginia, like the California False Claims Act and New York False Claims Act, is one of the states that allows individuals to pursue false claims submitted to the government in any industry. The Virginia Qui Tam Statute is not limited to just healthcare.
Settlement Under Virginia False Claims Act
The owner of several Richmond area medical support service companies have agreed to settle a civil fraud case. The complaint alleges her companies defrauded the Virginia Medicaid program of over $1 million. The case is captioned United States ex rel. Susana Mulcahey v. Open Arms Family Support Services, LLC, Civil No. 3:14 cv 316.
A list of the allegations include the following:
paying kickbacks to induce referrals;
submitting Medicaid claims to ineligible recipients; and
submission of claims to Medicaid for services not provided
In addition to paying a fine, the defendant agreed to a lifetime exclusion from the Medicaid program. This is alone is a good deterrent from committing fraud under the Virginia Qui Tam Statute.
WASHINGTON FALSE CLAIMS ACT
The State of Washington enacted a “Washington Qui Tam Statute” codified at Wash. Rev. Code Ann. § 74.66 et seq. The Washington False Claims Act (“WFCA”) is modeled after the Federal False Claims Act. Similar to the Federal False Claims Act, individuals with knowledge of fraud, waste, and abuse related to government funds can bring a qui tam lawsuit. If this qui tam lawsuit is successful, the whistleblower has the opportunity to receive an award. The whistleblower award ranges from 15-30% of the recovery dependent on certain factors.
Differences in the Washington False Claims Act
Much like the Texas False Claims Act, Arkansas False Claims Act, Maryland, Louisiana False Claims Act, and Connecticut False Claims Act s, under the Washington Qui Tam Statute, whistleblowers can only file qui tam actions when Medicaid funds are being misused.
This is unlike the False Claims Act, where whistleblowers can bring qui tam lawsuits when any and all federal government funds are being misused. A successful qui tam lawyer can walk you through the differences.
Legislative Background of Washington False Claims Act
The Washington False Claims Act was enacted in 2012. The reason it was enacted was to provide the State with another tool to combat Washington Medicaid fraud.
The legislature found that between 1996 and 2009 state initiated false claims acts resulted in over $5 billion in total recoveries to those states. The highest recoveries related to Medicaid fraud: billing fraud and off-label marketing. Moreover, these frauds related to pharmaceutical industry and hospital networks, hospitals and medical centers.
Because of the success of the Washington Qui Tam Statute as a fraud fighting tool, Washington has recovered money for taxpayers.
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