Do You Suspect Your Vermont Employer or Medical Provider Is Guilty of Medicaid Fraud?

Vermont Medicaid fraud costs taxpayers millions of dollars each year. Most Vermont Medicaid health care providers are honest and committed to providing quality patient care, but dishonest Vermont health care professionals and businesses continue to steal millions from Vermont Medicaid each year through fraudulent acts.

Nurses, physicians, EMT’s, sales representatives, clerks and other Vermont Medicaid health care professionals are in the unique position to detect Medicaid fraud at its source. In May 2015, Vermont legislature enacted the Vermont False Claims Act to provide those with information on Medicaid fraud the ability to file a claim on behalf of the state.

As incentive to report Vermont Medicaid fraud, the Vermont False Claims Act pays whistleblowers cash awards of between 10% and 30% of any government recovery. The Vermont False Claims Act also allows whistleblowers to seek damages in the event their Vermont health care employer retaliates against them for blowing the whistle.

Mere suspicion of Vermont Medicaid fraud is enough to make a report. If you have information on Vermont Medicaid fraud, you may be entitled to a large cash award. Contact the Medicaid Fraud Hotline 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 Vermont Medicaid Fraud

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What Vermont Laws Apply to Reporting Medicaid Fraud? (Title)

Under the Vermont False Claims Act (VFCA), 32 Vt. Stat. Ann. §§ 630 et seq., it is illegal to:

  • knowingly present a false or fraudulent claim for Medicaid payment or approval;
  • knowingly make a false record or statement material to a false or fraudulent claim;
  • knowingly present a claim that includes items or services resulting from bribery or a violation of the Social Security Act;
  • have possession of property or money used by the State, and knowingly deliver less than all of that property or money for which the person receives a certificate or receipt;
  • intending to defraud the State, make or deliver a receipt without completely knowing that the information on the receipt is true;
  • enter into a written agreement with a State official knowing the information contained therein is false;
  • knowingly make a false statement material to an obligation to pay or transmit money or property to the State;
  • knowingly conceal, avoid or decrease an obligation to pay or transmit money or property to the State;
  • discover the falsity of a claim or the receipt of overpayment and fail to disclose the error within 120 days of date on which the error was identified or the date the cost report is due; or
  • conspire to commit a violation of the VFCA.

"Knowing" and "knowingly" means 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. A violation of the VFCA requires no proof of specific intent to defraud.

Any person who violates the VFCA will be liable to the State for a civil penalty of between $5,500 and $11,000.00 for each violation, plus three times the amount of damages that the State sustains because of the violation and the costs of the investigation and prosecution of such violation.

Don’t let your whistleblower cash award go to someone else. You must be first to file a claim to be eligible to receive the 10% to 30% of any government recovery. Call the Medicaid Fraud Hotline now for a free, no obligation case evaluation.

Medicaid Fraud Hotline: 888.742.7248 or Report Online

What Protections Does Vermont Law Provide for Medicaid Fraud Whistleblowers?

Under the Vermont False Claims Act (VFCA), 32 Vt. Stat. Ann. §§ 630 et seq., an employer may not discharge, demote, suspend, threaten, harass, or in any other manner discriminate against an employee because of lawful acts the employee does to further an action or stop a violation of the VFCA.

In addition, employers may not enforce any rule or policy that prevents an employee from disclosing information or acting to further efforts to stop one or more violations of the VFCA. No employer may require that any employee agree to, accept or sign an agreement that limits or denies their right to provide information to a government agency pursuant to the VFCA.

Under the Vermont Health Care Employees Whistleblower Protection Law, 21 Vt. Stat. Ann. §§ 507-509, no employer shall take retaliatory action against any employee because the employee:

  • Discloses or threatens to disclose any activity that the employee reasonably believes is a violation of any law or constitutes improper quality of patient care.
  • Provides information to any public body conducting an investigation involving allegations that the employer violated any law or has engaged in behavior constituting improper quality of patient care.
  • Objects to or refuses to participate in any activity that the employee reasonably believes is in violation of a law or constitutes improper quality of patient care.

"Retaliatory action" means discharge, threat, suspension, demotion, denial of promotion, discrimination, or other adverse employment action.

Health care employees must first report the alleged violation of law or improper quality of patient care to the employer or supervisor and give the employer a reasonable opportunity to address the violation before filing a claim (unless the employee reasonably believes that doing so would not result in appropriate action).

Under the Vermont State Employees Labor Relations Act, 3 Vt. Stat. Ann. §§ 971-978, a State employer may not engage in retaliatory action against a State employee because the employee refuses to comply with an illegal order or provides a good faith report that alleges a violation of law or a threat to one’s health or assists in a proceeding to enforce these provisions.

An employee who brings a claim under the anti-retaliation provisions of the Vermont False Claims Act, Vermont Health Care Employees Whistleblower Protection Law, or Vermont State Employees Labor Relations Act may seek damages including:

  • reinstatement to the same position, seniority, and location held prior to the retaliatory action
  • two times back pay, lost wages, benefits
  • interest on back pay
  • injunctive relief
  • other compensatory damages
  • reasonable costs and attorney's fees.
Medicaid Fraud Hotline: 888.742.7248 or Report Online

What Cash Awards Are Available for Reporting Vermont Medicaid Fraud?

Under the Vermont False Claims Act (VFCA), 32 Vt. Stat. Ann. §§ 630 et seq., if the State proceeds with an action, the whistleblower is entitled to receive between 15% and 25% of the proceeds recovered in the action or settlement depending upon the extent to which the whistleblower substantially contributed to the prosecution of the action. If the Attorney General does not proceed with an action, the whistleblower may proceed on his own and will be entitled to receive between 25% and 30% of the proceeds recovered.

The whistleblower is also entitled receive an amount for reasonable expenses which the Court finds to have been necessarily incurred, including reasonable attorney's fees and costs.

Your report can help save taxpayer dollars, improve the quality of care for Vermont Medicaid beneficiaries and maintain a level playing field for health care providers. It is up to physicians, nurses, billing clerks, pharmacists, sales reps, EMTs and all other medical providers to report misuse and abuse of Vermont Medicaid funds. These whistleblowers are offered cash rewards, often in the millions of dollars, for evidence leading to successful government recovery of funds. If you have knowledge that your employer is submitting false claims to Medicaid, you may be eligible to receive a significant cash award. Contact the Medicaid Fraud Hotline today for a free, immediate and confidential case evaluation.

Medicaid Fraud Hotline: 888.742.7248 or Report Online

Are there Time Limits on Reporting Vermont Medicaid Fraud?

Under the Vermont False Claims Act (VFCA), 32 Vt. Stat. Ann. §§ 630 et seq., a whistleblower action must be brought:

  • within 6 years of the date on which the violation was committed, or
  • within 3 years of the date when facts material to the right of action are known or reasonably should have been known by the official within the Attorney General's office with responsibility to act, but
  • in no event more than 10 years after the date on which the violation is committed. whichever occurs last.

Whistleblower actions may be brought under the VFCA for activity prior to the enactment (May 18, 2015) as long as the limitations period has not lapsed.

Under the anti-retaliation provision of the Vermont False Claims Act (VFCA), 32 Vt. Stat. Ann. §§ 630 et seq., a civil action must be brought within 3 years of the date the retaliation occurred and became known to the employee.

Under the Vermont State Employees Labor Relations Act, 3 Vt. Stat. Ann. §§ 971-978, a claim must be brought within 180 days of the date of the alleged retaliatory action.

Medicaid Fraud Hotline: 888.742.7248 or Report Online

3 Easy Steps to Help you Decide

Whether You Should Report Medicaid Fraud

If you have information concerning Medicaid Fraud in the State of Vermont, contact the Medicaid Fraud Hotline or fill out the online report form. Timing is critical. First-to-file rules allow only the first to report their knowledge to receive a cash award, and statutes of limitations limit the amount of time you have to file a claim.

Vermont Pays Millions in Cash Awards for Information on Medicaid Fraud
Medicaid Fraud Hotline: 888.742.7248 or Report Online