Is Your Georgia Hospital, Clinic Or Pharmacy Employer Attempting To Profit From Medicaid Fraud?
Georgia Medicaid is a health insurance program organized to aid low-income families, individuals with disabilities and foster and adoptive children, and funded with state and federal taxpayer dollars. Unfortunately, dishonest Georgia hospitals, care clinics, pharmacies, emergency transport companies and medical device manufacturers attempt to pocket these funds by submitting false claims for payment, misrepresenting eligibility and participating in other corrupt schemes.
The Georgia Medicaid Fraud Control Unit (GMFCU) was established in 2011 to investigate fraud and abuse by providers participating in the Georgia Medicaid program. Since its inception, the GMFCU has recovered over $190 million in stolen taxpayer dollars. Nurses, physicians, bookkeepers, EMT’s pharmacists and others in the health care profession play a key role in detecting incidents of Georgia Medicaid Fraud and have walked away with millions in cash whistleblower awards for their information.
Georgia State and Federal False Claims Acts provide whistleblowers with anti-retaliation protection and massive financial incentives to come forward. If you feel your employer is submitting false claims to Georgia Medicaid, you may be entitled to a significant cash award. Time to file your claim is limited. Call today for a free, immediate and confidential case evaluation.
Review the Various Types of Medicaid Fraud
Reporting Georgia Medicaid Fraud
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What Georgia Laws Govern the Right to Report Medicaid Fraud?
The Georgia False Medicaid Claims Act (GFMCA), Ga. Code Ann. §§ 49-4-168 et seq., makes it a crime for any person, corporation, company, association, firm, partnership, society or joint-stock company to knowingly submit false claims for payment to Georgia Medicaid.
“Knowingly” requires no proof of specific intent to defraud and means that the fraudster:
- 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.
Violations of the GFMCA include:
- Knowingly presenting or causing to be presented a false or fraudulent claim for payment or approval to the Georgia Medicaid program;
- Knowingly making, using, or causing to be made or used a false record or statement material to a false or fraudulent claim;
- Conspiring to defraud the Georgia Medicaid program by getting a false or fraudulent claim allowed or paid;
- Having possession, custody, or control of property or money used or to be used by the Georgia Medicaid program and knowingly delivering, or causing to be delivered, less than all of such property or money;
- Making or delivering a document certifying receipt of property used, or to be used, by the Georgia Medicaid program and, intending to defraud the Georgia Medicaid program, making or delivering the receipt without completely knowing that the information on the receipt is true;
- Knowingly buying, or receiving as a pledge of an obligation or debt, public property from an officer or employee of the Georgia Medicaid program who lawfully may not sell or pledge the property; or
- Knowingly making, using, or causing to be made or used a false record or statement material to an obligation to pay or transmit property or money to the Georgia Medicaid program, or knowingly concealing, avoiding or decreasing an obligation to pay or transmit property or money to the Georgia Medicaid program.
Penalties for violating the GFMCA include a fine of not less than $5,500 and not more than $11,000 for each false or fraudulent claim, plus three times the amount of damages which the Georgia Medicaid program sustains because of the misconduct.
The person or agency violating the GFMCA is also liable for all costs of any civil action brought to recover damages and penalties.
If the person committing the violation self-reports within 30 days after learning of the violation and fully cooperates in any investigation, and no action is underway at the time they self-report, penalties may be reduced to not more than two times the amount of the actual damages which the Georgia Medicaid program sustained because of the misconduct.
Putting a stop to health care fraud, waste and abuse is of utmost importance in defending our nation’s health care programs and keeping health care costs low for ourselves and future generations. The Georgia Medicaid Fraud Control Unit relies on health care professionals to report any information they may have regarding Georgia Medicaid Fraud. If you suspect your employer or other entity may be engaged in Medicaid Fraud, whether intentionally or accidentally, you are protected by law from retaliation and may receive a large cash reward for your information. Don’t wait to make the call – statutes of limitations apply on filing a claim. Call the Medicaid Fraud Hotline Today.
What Georgia Laws Provide Protection For Those Reporting Medicaid Fraud?
Whistleblower Protections under the Georgia False Medicaid Claims Act
Under the Georgia False Medicaid Claims Act (GFMCA), Ga. Code Ann. §§ 49-4-168 et seq., any employee, contractor or agent who is discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against in the terms and conditions of employment because of lawful acts done in furtherance of a civil action or in any other effort to stop a violation of the GFMCA, is entitled to all relief necessary to make the employee, contractor or agent whole, including:
- Reinstatement with the same seniority status the employee, contractor, or agent would have had but for the discrimination
- Two times 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 attorney’s fees
Whistleblower Protections under Georgia’s Whistleblower Act for Public Employees
Georgia Whistleblower Act for Public Employees, Ga. Code Ann. §§ 45-1-4 et seq., makes it a crime for public employers to retaliate against an employee who has placed a complaint in order to prevent fraud, abuse or misuse of public funds.
Georgia employees working in the health care arena are protected under these Georgia statutes from employers taking retaliatory action against them in response to reporting fraud against Georgia Medicaid. If you have experienced or fear you may be exposed to harassment, threats or other forms of discrimination for reporting your knowledge, you may have a claim to collect damages. Don’t be bullied into a corner. Stand up for what is right and help protect our nation’s health care programs and valuable taxpayer dollars. Contact the Medicaid Fraud Hotline now.
What Cash Award Amounts Are Paid for Reporting Georgia Medicaid Fraud?
Under the Georgia False Medicaid Claims Act (GFMCA), Ga. Code Ann. §§ 49-4-168 et seq., if the Attorney General proceeds with a civil action, the whistleblower is entitled to between 15% and 25% of the proceeds of the civil action or settlement of the claim, depending upon the extent to which the person substantially contributed to the prosecution of the civil action.
Because penalties for violating the GFMCA can equal from $5,500 to $11,000 PER false claim, plus three times damages, proceeds often fall within the millions of dollars. This means whistleblower cash awards are commonly in the hundreds of thousands to millions of dollars range.
If the Attorney General does not proceed with a civil action, the whistleblower is entitled to between 25% and 30% of the proceeds of the civil action or settlement, an amount which the court decides is reasonable for collecting the civil penalty and damages.
Whistleblowers are also eligible to receive costs for reasonable expenses which the court finds to have been necessarily incurred, plus reasonable attorney’s fees and costs.
With the large cash incentives and powerful legal protections the Georgia False Medicaid Claims Act and Georgia Whistleblower laws provide, there is no reason to put off reporting suspected Georgia Medicaid Fraud. Statutes of limitations and first-to-file provisions mean whistleblowers only have so much time to get their claim filed. Don’t wait! Call the Medicaid Fraud Hotline now for a free, immediate and no-obligation consultation.
What are Georgia Statutes of Limitations on Reporting Medicaid Fraud or Employer Retaliation?
Under the Georgia False Medicaid Claims Act (GFMCA), Ga. Code Ann. §§ 49-4-168 et seq., all civil actions must be filed:
- within 6 years after the date the violation was committed;
- or 4 years after the date when facts of the false claim are known or reasonably should have been known by the state official charged with the responsibility to act in the circumstances, whichever occurs last;
- in no event shall any civil action be filed more than 10 years after the date upon which the violation was committed.
To file a civil action for damages due to employer retaliation, the GFMCA requires a claim be brought within 3 years of the date when the discrimination occurred.
Under the Georgia Whistleblower Act for Public Employees, Ga. Code Ann. §§ 45-1-4et seq., employees must file a lawsuit within 1 year of discovering a discriminatory act OR within 3 years of the act, whichever is earlier.
3 Easy Steps to Help you Decide
Whether You Should Report Medicaid Fraud
If you have information regarding Medicaid Fraud in the State of Georgia, contact the Medicaid Fraud Hotline or fill out the online report form. You must be the first to file a claim to be eligible for the cash whistleblower reward. Secure your role as whistleblower now.
Millions in Cash Paid for Information Leading to Government Recovery