Is Your Maryland Employer or other Medical Provider Guilty of Medicaid Fraud?
Maryland Medicaid supplies low income Maryland residents with quality medical care funded by Maryland taxpayers. In 2015, the Maryland Medicaid Fraud Control Unit (MFCU) recovered nearly $4.5 million in stolen Maryland Medicaid funds. Whistleblowers – health care professionals and others who report knowledge of Maryland Medicaid fraud - are a key component in these recoveries.
Dishonest clinics, hospitals, physicians, nurses, home health care agencies, pharmacies or medical transportation companies may scheme to steal tax dollars from government health care programs by submitting false or fraudulent claims to Maryland Medicaid. If you suspect a medical professional is committing fraud against Maryland Medicaid, report your information now. Contact the Medicaid Fraud Hotline and secure your cash whistleblower award.
Review the Various Types of Medicaid Fraud
Reporting Maryland Medicaid Fraud
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What Maryland Laws Apply to Reporting Medicaid Fraud?
Under the Maryland False Claims Act (MFCA), Md. Code Ann. Gen. Prov. § 8-101, et seq., it is a crime to submit false claims for payment to a government program. The MFCA enables private citizens with knowledge of fraud to file a claim on behalf of the government, protects whistleblowers from employer retaliation in response to reporting fraud, and pays significant cash whistleblower awards for information leading to successful recovery.
Under the MFCA, a person may not:
- Knowingly present or cause to be presented a false or fraudulent claim for payment or approval;
- Knowingly make, use, or cause to be made or used a false record or statement material to a false or fraudulent claim;
- Conspire to commit a violation under this subtitle;
- Have possession, custody, or control of money or other property used by or on behalf of the State under a State health plan or a State health program and knowingly deliver or cause to be delivered to the State less than all of that money or other property;
- Be authorized to make or deliver a receipt or other document certifying receipt of money or other property used or to be used by the State under a State health plan or a State health program; and (ii) Intending to defraud the State or the Department, make or deliver a receipt or document knowing that the information contained in the receipt or document is not true;
- Knowingly buy or receive as a pledge of an obligation or debt publicly owned property from an officer, employee, or agent of a State health plan or a State health program who lawfully may not sell or pledge the property;
- Knowingly make, use, or cause to be made or used, a false record or statement material to an obligation to pay or transmit money or other property to the State;
- Knowingly conceal, or knowingly and improperly avoid or decrease, an obligation to pay or transmit money or other property to the State; or
- Knowingly make any other false or fraudulent claim against a State health plan or a State health program.
“Knowing” or “knowingly” means that a person:
(i) Has actual knowledge of the information;
(ii) Acts in deliberate ignorance of the truth or falsity of the information; or
(iii) Acts in reckless disregard of the truth or falsity of the information.
"Knowing" or "knowingly" does not mean that a person acts in a manner that constitutes mistake or negligence.
Any person who violates the MFCA is liable to the state for a civil penalty of up to $10,000 for each false or fraudulent claim, plus up to three times the amount of damages the state sustains.
Whether you just suspect misconduct in the workplace, or you have absolute evidence of Maryland Medicaid fraud, don’t hesitate to contact the Medicaid Fraud Hotline. The State of Maryland depends on individuals who uphold honesty and integrity in Maryland’s health care industry and protect Maryland taxpayer dollars. Federal and state laws provide protection and significant whistleblower cash rewards to those who report information regarding Maryland Medicaid fraud.
Your privacy is guaranteed. Contacting the Medicaid Fraud Hotline does not obligate you to pursue a case.
Does Maryland Law Provide Protection For Those Reporting Medicaid Fraud?
Whistleblower Protections under the Maryland False Claims Act
Under the Maryland False Claims Act (MFCA), Md. Code Ann. Gen. Prov. § 8-101, et seq., any employee, contractor, or grantee who is discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against because of lawful acts done in furtherance of an MFCA action or other efforts to stop one or more violations of the MFCA is entitled to all relief necessary to make that employee, contractor, or agent whole.
Specifically, retaliatory action may not be taken because the employee, contractor or grantee:
- Acts lawfully in furtherance of an action filed under the MFCA, including an investigation for, initiation of, testimony for, or assistance in an action filed or to be filed under this subtitle;
- Discloses or threatens to disclose to a supervisor or to a public body an activity, policy, or practice of the person that the employee, contractor, or grantee reasonably believes is in violation of § 2-602(a) of this subtitle or a regulation adopted under this subtitle;
- Provides information to, or testifies before, a public body conducting an investigation, hearing, or inquiry into a violation of § 2-602(a) of this subtitle or a regulation adopted under this subtitle that is allegedly or actually committed by the person; or
- Objects to or refuses to participate in any activity, policy, or practice that the employee, contractor, or grantee reasonably believes is in violation of § 2-602(a) of this subtitle or a regulation adopted under this subtitle.
Whistleblower Protections under Maryland’s Health Care Worker Whistleblower Protection Act
The Maryland Health Care Worker Whistleblower Protection Act (MHWPA), MD Code, Health Occupations, § 1-501-506, protects health care workers from employer retaliation in response to disclosing or participating in an investigation regarding any violation of a rule, law, or regulation that could substantially harm the public.
Whistleblowers Are Entitled To Remedies When Subjected to Employer Retaliation
Under the both the MFCA and the MHWPA, whistleblowers who experience workplace retaliation are entitled to all damages essential to “make the employee whole.” These remedies may include:
- an injunction to restrain a continuing violation;
- reinstatement to the same seniority status held before the retaliatory action;
- reinstatement of full fringe benefits and seniority rights;
- two times the amount of lost wages, benefits, and other remuneration, including any interest accumulated;
- payment by the person of reasonable costs and attorney’s fees;
- punitive damages;
- an assessment of a civil penalty not exceeding $1,000 for the first violation; and not exceeding $5,000 for each subsequent violation; and
- any other relief necessary to make the employee, contractor, or grantee whole.
What Cash Awards Are Available for Reporting Maryland Medicaid Fraud?
Under the Maryland False Claims Act (MFCA), Md. Code Ann. Gen. Prov. § 8-101, et seq., after filing a whistleblower claim, the state may opt to intervene in the investigation and prosecution. Maryland law requires intervention by the state to proceed with an action and whistleblowers cannot proceed without the state’s involvement.
If the state proceeds with an action brought by a whistleblower, the whistleblower shall receive between 15% and 25% of the proceeds of the action or settlement of the claim. The whistleblower shall also receive an amount for reasonable expenses, plus reasonable attorney fees and costs.
The specific percentage of the cash award to be paid will be determined based upon the extent to which the whistleblower substantially contributes to the final resolution of the action.
Federal and state whistleblower laws and False Claims Acts are key weapons in combatting dishonest medical providers, pharmaceutical companies and medical device manufacturers who scheme to profit illegally from government-funded health care programs. If you suspect your Maryland employer, other agency or medical provider is acting to defraud the Maryland Medicaid program, contact the Medicaid Fraud Hotline now for a no-cost, completely confidential case evaluation.
What is the Maryland Statute of Limitations on Reporting Medicaid Fraud?
Under the Maryland False Claims Act (MFCA), Md. Code Ann. Gen. Prov. § 8-101, et seq., a whistleblower claim must be brought
- within six years after the date on which the violation is committed,
- or more than three years after the date when facts material to the right of action are known or reasonably should have been known by the official of state charged with responsibility to act in the circumstances,
- but in no event more than ten years after the date on which the violation is committed, whichever occurs last.
Common forms of Maryland Medicaid fraud involve overbilling, false documentation, medical necessity fraud, off-label promotion, kickbacks and Stark Law violations. The Medicaid Fraud Hotline protects the rights and privacy of health care employees and other individuals who chose to report Maryland Medicaid Fraud. Call today and secure your role as whistleblower.
3 Easy Steps to Help you Decide
Whether You Should Report Medicaid Fraud
Don’t wait or you may forfeit your cash reward. Whistleblower laws contain first-to-file provisions. Only the first whistleblower to report the fraud is eligible to collect the large cash award. Statutes of limitations limit the amount of time a whistleblower has to file a claim. Once you make the call, you solidify your role as whistleblower. Call the Medicaid Fraud Hotline today.
Over $1 Million in Cash Awards for Tips Leading to Government Recovery