Do You Have Knowledge of Alabama Medicaid Fraud?

Many dishonest health care industry professionals continue to ignore Alabama Medicaid rules and regulations in an effort to pocket taxpayer dollars for themselves. Every Alabama taxpayer pays for the crime of Alabama Medicaid fraud through the loss of valuable government services and injurious tax increases.

In 2015 alone, the Alabama Medicaid Fraud Control Unit (MFCU) investigated nearly 50 reports of fraud, waste and abuse, resulting in 9 criminal convictions and 5 civil settlements and judgements. That same year, the Alabama MFCU recovered over $5 million in stolen taxpayer dollars for the state. In fiscal year 2014, the federal government recovered $2.3 billion in False Claims Act settlements and judgments involving government health care programs like Medicare, Medicaid and TRICARE. Many of these recoveries result from the reports of whistleblowers – health care professionals who report inside knowledge of fraud.

If you have information regarding Medicaid Fraud, you may be entitled to a significant cash award. Call today for a free, immediate and confidential case evaluation.

Medicaid Fraud Hotline: 888.742.7248 or Report Online

Review the Various Types of Medicaid Fraud

Reporting Alabama Medicaid Fraud

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What Laws Apply to Reporting Alabama Medicaid Fraud?

The federal False Claims Act (FCA), 31 U.S.C. §§ 3729 - 3733, allows private citizens to file a whistleblower (qui-tam) lawsuit on behalf of the federal government against individuals or entities they suspect have submitted false claims to Medicare, Medicaid, TRICARE or other government health care programs. Whistleblowers whose information leads to a successful settlement or verdict are entitled to between 10% and 30% any money recovered and may sue for damages in cases of employer retaliation in response to their actions in putting a stop to the violations.

Though Alabama does not have its own state FCA, the conduct that supports a claim under a state FCA is often also in violation of the federal FCA. The federal FCA is violated by any person who:

  • 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;
  • Conspires to commit a violation of the federal FCA;
  • Has possession, custody, or control of property or money used, or to be used, by the government and knowingly delivers, or causes to be delivered, less than all of that money or property;
  • Is authorized to make or deliver a document certifying receipt of property used, or to be used, by the government and, intending to defraud the government, makes or delivers the receipt without completely knowing that the information on the receipt is true;
  • Knowingly buys, or receives as a pledge of an obligation or debt, public property from an officer or employee of the government, or a member of the Armed Forces, who lawfully may not sell or pledge property; or
  • Knowingly makes, uses, or causes to be made or used, a false record or statement material to an obligation to pay or transmit money or property to the government, or knowingly conceals or knowingly and improperly avoids or decreases an obligation to pay or transmit money or property to the government.

The terms “Knowing” and “knowingly” mean that a person has actual knowledge of the information; acts in deliberate ignorance of the truth or falsity of the information; or acts in reckless disregard of the truth or falsity of the information. No proof of specific intent to defraud is required.

Individuals who violate the federal FCA are liable to the United States government for a civil penalty of between $5,000 and $10,000, plus three times the amount of damages sustained by the government and the costs of any civil action brought to recover any such penalty or damages.

Because whistleblower knowledge of Alabama Medicaid fraud is crucial, the federal FCA awards whistleblowers with 10% to 30% of any government recovery. Alabama nurses, physicians, medical equipment companies, dentists, pharmacists, EMTs and other health care professionals who serve Alabama Medicaid beneficiaries are in a unique position to discover and report fraud.

Medicaid Fraud Hotline: 888.742.7248 or Report Online

What Protection Does the Law Provide For Those Reporting Alabama Medicaid Fraud?

Under the federal False Claims Act (FCA), 31 U.S.C. §§ 3729 - 3733, no employer, contractor or agent may discharge, demote, suspend, threaten, harass or in any other manner discriminate against an employee, contractor or agent because of lawful acts done by the employee, contractor, agent or a person associated with the employee, contractor or agent in furtherance of an FCA action or other efforts to stop a violation of the FCA.

Whistleblowers Are Entitled To Remedies When Subjected to Employer Retaliation

Under the federal FCA, whistleblowers who experience workplace retaliation are entitled to remedies including:

  • Reinstatement with the same seniority status the employee, contractor or agent would have had but for the discrimination
  • Twice the amount of back pay
  • Interest on the back pay
  • Compensation for any special damages sustained as a result of the discrimination
  • Litigation costs and reasonable attorneys' fees
Medicaid Fraud Hotline: 888.742.7248 or Report Online

What Cash Awards Are Available for Reporting Alabama Medicaid Fraud?

Under the federal False Claims Act (FCA), 31 U.S.C. §§ 3729 - 3733, a whistleblower who files the initial complaint is entitled to the following amounts if the government prevails in the action:

  • If the government choses to intervene, the whistleblower is entitled to between 15% and 25% of the proceeds of the action or settlement, plus reasonable attorneys’ fees and an amount to cover the expenses and costs of bringing the action.
  • If the government opts not to intervene, the whistleblower is entitled to between 25% and 30% of the proceeds of the action or settlement, plus reasonable attorneys’ fees and an amount to cover the expenses and costs of bringing the action.

Final award amounts are determined based upon the significance of the whistleblower’s information and the extent to which the whistleblower aids in the investigation and advancing the case to litigation.

A whistleblower’s decision to report Alabama Medicaid fraud directly influences the government’s ability to prosecute cases and stop fraud, waste and abuse of taxpayer dollars. Alabama Medicaid provides health care services for low-income children, adults and elderly individuals who could not otherwise afford care.

The federal and state governments apportion tax dollars carefully to ensure adequate funding of such programs. When these funds are abused, every Alabama resident suffers. Help put a stop to Alabama Medicaid fraud. Call now for a free, no-obligation case evaluation.

Medicaid Fraud Hotline: 888.742.7248 or Report Online

What is the Statute of Limitations on Reporting Alabama Medicaid Fraud?

Under the federal False Claims Act (FCA), 31 U.S.C. §§ 3729 - 3733, a whistleblower lawsuit must be brought:

  • Within 6 years after the date on which the violation is committed, or
  • Within 3 years after the date when facts material to the right of action are known or reasonably should have been known, and
  • No longer than 10 years after the date on which the violation is committed.

A civil action under the anti-retaliation provisions of the federal FCA must be brought within 3 years of the date the retaliation occurred.

The federal government pays a substantial cash award, often in the hundreds of thousands to millions of dollars range, to whistleblowers whose report of Alabama Medicaid fraud leads to government recovery. In addition, Alabama’s State Employment Protection Act gives anti-retaliation protections to individuals who step forward and report misconduct. If you feel you have knowledge of Alabama Medicaid fraud, don’t hesitate to contact the Medicaid Fraud Hotline.

Medicaid Fraud Hotline: 888.742.7248 or Report Online

2 Easy Steps to Help you Decide

Whether You Should Report Medicaid Fraud

If you have information regarding Medicaid Fraud in the State of Alabama, contact the Medicaid Fraud Hotline or fill out the online report form. Remember, you must be the FIRST to report to secure your role as whistleblower and be eligible for a cash award. Statutes of limitations apply.

Over $1 Million in Cash Awards for Tips Leading to Government Recovery
Medicaid Fraud Hotline: 888.742.7248 or Report Online