Is Your Hawaii Health Care Employer Guilty of Medicaid Fraud?

Is Your Hawaii Health Care Employer Submitting False Claims to Medicaid?

As one of the first six states to implement a Medicaid program, Hawaii was rated Healthiest State in the Nation by Gallup Healthways Well-Being Index in 2015. By funding Medicaid, Hawaiian taxpayers help to care for over 300,000 low-income, children, adults and elderly Hawaii residents. Unfortunately, corrupt individuals and agencies in the Hawaiian health care industry continue to pocket hard-earned taxpayer dollars for themselves by illegally billing Hawaii Medicaid for services not provided, products of a higher quality than provided, illegal kickbacks, and misrepresentation.

In 2014, the Department of Human Services’ Med-QUEST Division reported $67 million in taxpayer dollars went to criminals engaging in Hawaii Medicaid fraud. The role of the Hawaii Medicaid Fraud Control Unit is to investigate and prosecute cases of Hawaii Medicaid fraud, yet government resources dedicated to the discovery of these incidents are limited. It is up to nurses, physicians, bookkeepers, EMT’s, sales representatives, pharmacists and other health care industry professionals to increase the effectiveness of government resources. You are in the unique position to access inside information on Medicaid fraud, waste and abuse.

Hawaii State and Federal False Claims Acts provide whistleblowers with powerful protection and significant financial incentives to blow the whistle on fraudulent activity. Medicaid fraud robs Hawaiian taxpayers of millions each year and increases the cost of health care for everyone. If you feel you have knowledge of Hawaii Medicaid fraud, you may be entitled to a cash award of over $1 million. Call today for a free, immediate and confidential case evaluation.

Review the Various Types of Medicaid Fraud

Reporting Hawaii Medicaid Fraud

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What Laws Cover Reporting Hawaii Medicaid Fraud?

Under the Hawaii State False Claims Act (HFCA), Haw. Rev. Stat. §§ 661-21 et seq., private individuals may bring a civil action on behalf of the State of Hawaii regarding submission of false claims to Hawaii Medicaid. In order to be eligible to file a claim, the whistleblower must have “direct and independent knowledge” of the evidence of a violation, meaning the allegations cannot be based upon any information available to the general public through television, radio, media or internet.

The HFCA makes it a crime to:

1. Knowingly present, or cause to be presented, a false or fraudulent claim for payment or approval to the State;
2. Knowingly make, use, or cause to be made or used, a false record or statement to get a false or fraudulent claim paid or approved by the State;
3. Conspire to defraud the State by getting a false or fraudulent claim allowed or paid;
4. Have possession, custody, or control of property or money used, or to be used, by the State, and with intent to defraud the State or willfully conceal the property, deliver, or cause to be delivered, less property than the amount for which the person receives a certificate or receipt;
5. Make or deliver a document certifying receipt of property used, or to be used by the State, and with intent to defraud the State, make or deliver the receipt without completely knowing that the information on the receipt is true;
6. Knowingly buy, or receive as a pledge of an obligation or debt, public property from any officer or employee of the State who may not lawfully sell or pledge the property;
7. Knowingly make, use, or cause to be made or used, a false record or statement to conceal, avoid, or decrease an obligation to pay or transmit money or property to the State; or
8. Be a beneficiary of an inadvertent submission of a false claim to the State, subsequently discover the falsity of the claim, and fail to disclose the false claim to the State within a reasonable time after discovery of the false claim.

Proof of intent to defraud Hawaii Medicaid is not required to be liable under the HFCA.

Penalties for violating the HFCA include civil penalties of between $5,000 and $10,000, plus three times the amount of damages the State of Hawaii sustains due to the violation and costs and attorneys’ fees.

Penalties may be reduced to not less than twice the amount of damages the state sustains due to the violation if the person committing the misconduct reports their violation within 30 days of discovering it, fully cooperates in any state investigation, no civil or criminal action is currently underway with respect to the violation, and the person did not have actual knowledge of any investigation into the misconduct.

The HFCA requires that former or present employees of the State must report the violation to a supervisor or other internal source upon learning of the violation before filing a claim under the HFCA.

Fighting back against Medicaid Fraud is a vital step in safeguarding our nation’s health care programs for future generations. If you suspect your Hawaii health care employer is guilty of Medicaid Fraud, you are protected by federal and state whistleblower laws and may be entitled to a substantial cash award for your information. Contact the Medicaid Fraud Hotline Now.

Are Whistleblowers Protected From Employer Retaliation When Reporting Hawaii Medicaid Fraud?

Yes. Unlike the federal False Claims Act, the Hawaii State False Claims Act (HFCA) does not provide anti-retaliation protections to whistleblowers. Instead, Hawaii has whistleblower protection laws that individuals can use to file a claim for damages due to employer retaliation in response to their reporting Hawaii Medicaid fraud.

Under the Hawaii Whistleblowers’ Protection Act (HWPA), Haw. Rev. Stat. §§ 378-61 et seq., both public and private employers cannot discharge, threaten or otherwise discriminate against an employee or their representative for reporting or preparing to report a violation or suspected violation against the State, or for participating in a hearing, inquiry, investigation or court action, unless that employee knows the report to be false.

Penalties for violation the HWPA include a fine of between $500 and $5000 for each violation.

Public and private employees who have experienced retaliation for their employer in response to reporting or planning to report Hawaii Medicaid Fraud may file a claim for damages including:

• Job reinstatement
• Payment of lost wages
• Full reinstatement of benefits
• Full reinstatement of seniority rights
• Actual damages
• Any other appropriate relief
• Court costs and attorneys’ fees

If you have been fired, demoted, threatened, harassed or otherwise discriminated against by your employer for reporting or planning to report Hawaii Medicaid fraud, you may be eligible to file a claim for damages. Timing is critical so don’t wait to file a claim. Call the Medicaid Fraud Hotline now for a free, no-obligation case evaluation.

What Cash Awards Are Offered for Reporting Hawaii Medicaid Fraud?

Under the Hawaii State False Claims Act (HFCA), Haw. Rev. Stat. §§ 661-21 et seq., if the State intervenes in the action, the whistleblower is entitled to 15-25% of the total government recovery. In cases for which the State declines to intervene, the whistleblower award increases to 25-30% of the government recovery. In both scenarios, the whistleblower is also awarded reasonable attorney’s fees and costs.

The government’s ability to successfully recover stolen taxpayer dollars under the Hawaii False Claims Act is largely dependent on whistleblowers coming forward to expose a company’s violations. Under the federal False Claims Act, the government recovered approximately $3 billion dollars in 2014 as a result of whistleblowers reporting fraud. These whistleblowers collected over $435 million in cash awards as a result of their disclosures. If you have information of Hawaii Medicaid Fraud, call today and discover if you are eligible for a whistleblower cash award.

Are There Time Limits on Reporting Hawaii Medicaid Fraud?

Under the Hawaii State False Claims Act (HFCA), Haw. Rev. Stat. §§ 661-21 et seq., an action must be brought:

• Within 6 years of the date the violation is discovered, or “by exercise of reasonable diligence should have been discovered,” and
• No later than 10 years after the violation occurred.

The HFCA contains a first-to-file bar preventing anyone from filing a claim based on information that has already been reported. Only the first to report knowledge of Hawaii Medicaid Fraud is eligible for a cash whistleblower award.

Under the Hawaii Whistleblowers’ Protection Act (HWPA), Haw. Rev. Stat. §§ 378-61 et seq., the employee must file a claim for damages due to employer retaliation within 90 days of the most recent alleged violation of the HWPA.

If you have information regarding Hawaii Medicaid Fraud, contact the Medicaid Fraud Hotline or fill out the online report form. Timing is critical. You must be the first to act 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