Do You Suspect Your Employer or Medical Provider is Defrauding Idaho Medicaid?
Idaho Medicaid fraud costs taxpayers millions of dollars each year. Most Idaho Medicaid health care providers are trustworthy individuals committed to providing quality patient care, but dishonest Idaho health care professionals and businesses continue to steal millions from Idaho Medicaid each year through fraud, waste and abuse of government funds.
In fiscal year 2015, the Idaho Medicaid Fraud Control Unit (MFCU) investigated 108 reports of fraud, waste and abuse, resulting in four criminal convictions and 11 civil settlements and judgements. That same year, the Idaho MFCU recovered over $796 thousand in stolen taxpayer dollars. Physicians, nurses, EMT’s, pharmacists, sales representatives, clerks and other Idaho Medicaid health care professionals are in the unique position to discover cases of Medicaid fraud.
The government provides cash incentives to report Idaho Medicaid fraud. The federal False Claims Act pays whistleblowers cash awards of between 10% and 30% of any government recovery and allows whistleblowers to seek damages in the event their Idaho health care employer retaliates against them for blowing the whistle.
Even mere suspicion of Idaho Medicaid fraud is enough to make a report. If you have information on Idaho 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.
Review the Various Types of Medicaid Fraud
Reporting Idaho Medicaid Fraud
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What Laws Apply to Reporting Idaho 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 Idaho 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.
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.
What Protections Does the Law Provide for Idaho Medicaid Fraud Whistleblowers?
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
Whistleblower cash rewards often fall in the hundreds of thousands to millions of dollars range when evidence leads to successful government recovery of funds. If you have knowledge that your employer is submitting false claims to Idaho 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.
What Cash Awards Are Available for Reporting Idaho 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.
Your report can help save taxpayer dollars and improve the quality of care for thousands of Idaho Medicaid beneficiaries. It is the duty of nurses, doctors, bookkeepers, pharmacists, sales reps and all other health care professionals to report misuse and abuse of Idaho Medicaid funds. Contact the Medicaid Fraud Hotline today for a free, immediate and confidential case evaluation.
Are there Time Limits on Reporting Idaho 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.
2 Easy Steps to Help you Decide
Whether You Should Report Medicaid Fraud
If you have information concerning Medicaid Fraud in the State of Idaho, 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.
Millions in Cash Awards for Information on Idaho Medicaid Fraud