Is Your Iowa Employer or other Medical Provider Guilty of Medicaid Fraud?
Iowa Medicaid supplies over 570 thousand children, adults and elderly residents with quality medical care funded by Iowa taxpayers. In 2015, the Office of Inspector General, U.S. Department of Health and Human Services estimated a 10% (more than $467 million) loss of Iowa Medicaid dollars to fraud, waste and abuse. In 2014, the Iowa Medicaid Fraud Control Unit (MFCU) recovered $24.4 million in stolen Iowa Medicaid funds, most through the aid of whistleblowers – health care professionals and others who report knowledge of Iowa Medicaid Fraud.
Doctors, nurses, home health care agencies, hospitals, pharmacies, clinics and medical transportation companies may scheme to steal tax dollars from government health care programs by submitting false claims to Iowa Medicaid. If you suspect a medical provider is committing fraud against Iowa Medicaid, don’t delay. Contact the Medicaid Fraud Hotline and secure your cash whistleblower award.
Review the Various Types of Medicaid Fraud
Reporting Iowa Medicaid Fraud
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What Iowa Laws Apply to Reporting Medicaid Fraud?
Under the Iowa False Claims Act (IFCA), IA Code §§ 685.1 et seq., it is a crime to submit false claims for payment to a government program. The IFCA 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 IFCA, it is a crime to:
- 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 of the IFCA
- Have possession, custody, or control of property or money used, or to be used, by the state and knowingly deliver, or cause to be delivered, less than all of that money or property.
- Intending to defraud the state, make or deliver a receipt without completely knowing that the information on the receipt is true.
- Knowingly buy, or receive as a pledge of an obligation or debt, public property from an officer or employee of the state, or a member of the Iowa national guard, who lawfully may not sell or pledge 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 property to the state, or knowingly conceal or knowingly and improperly avoid or decrease an obligation to pay or transmit money or property to the state.
“Knowing” or “knowingly” means that a person:
- Has actual knowledge of the information.
- Acts in deliberate ignorance of the truth or falsity of the information.
- Acts in reckless disregard of the truth or falsity of the information.
“Knowing” or “knowingly” does not require proof of specific intent to defraud.
Any person who violates the IFCA is liable to the state for a civil penalty of between $5,500 and $11,000 for each false or fraudulent claim, plus three times the amount of damages the state sustains.
Whether you are merely suspicious of fraudulent behavior in the workplace, or you are confident your information is important, don’t wait to contact the Medicaid Fraud Hotline. The government depends on individuals who uphold honesty and transparency in Iowa’s health care industry and wish to protect Iowa taxpayer dollars. The government pays significant and well-earned whistleblower cash rewards to those who report information regarding Iowa Medicaid fraud.
Your privacy is guaranteed. Contacting the Medicaid Fraud Hotline does not obligate you to pursue a case.
Does Iowa Law Provide Protection For Those Reporting Medicaid Fraud?
Whistleblower Protections under the Iowa False Claims Act
Under the Iowa False Claims Act (IFCA), IA Code §§ 685.1 et seq., any employee, contractor, or agent is entitled to all relief necessary to make that employee, contractor, or agent whole, if that employee, contractor, or agent 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 an IFCA action or other efforts to stop one or more violations of the IFCA.
Whistleblower Protections under Iowa’s State Employee Protection Act
Under Iowa’s State Employee Protection Act, IA Code §§ 70A.28, a state employer cannot prohibit an employee of the state from disclosing any information internally or externally if the employee reasonably believes the information evidences a violation of law or rule, mismanagement, gross abuse of funds, an abuse of authority, or a substantial and specific danger to public health or safety.
A state employee is not allowed to discharge or deny an appointment or promotion because an employee has reported information they reasonably believe evidences a violation of law or rule, mismanagement, gross abuse of funds, an abuse of authority, or a substantial and specific danger to public health or safety.
Whistleblowers Are Entitled To Remedies When Subjected to Employer Retaliation
Under the Iowa False Claims Act (IFCA), IA Code §§ 685.1 et seq., and other Iowa whistleblower statutes, whistleblowers who experience workplace retaliation are entitled to all damages essential to “make the employee whole.” These remedies include:
- Reinstatement of your position with comparable seniority as you would have but for the discrimination
- Two times the amount of any back pay lost during change in position
- Interest on any back pay lost during change in position
- Reasonable attorneys’ fees and other litigation costs incurred
- Possible compensation for other damages directly resulting from the discrimination
State whistleblower laws and False Claims Acts are the number one weapon against dishonest medical providers, pharmaceutical companies and medical device manufacturers who scheme to steal taxpayer dollars and profit illegally from government-funded health care programs. If you suspect your Iowa employer, other agency or medical provider is acting to defraud the Iowa Medicaid program, contact the Medicaid Fraud Hotline now for a no-cost, completely confidential case evaluation.
What Cash Awards Are Available for Reporting Iowa Medicaid Fraud?
Under the Iowa False Claims Act (IFCA), IA Code §§ 685.1 et seq., after filing a whistleblower claim, the state may opt to intervene in the investigation and prosecution. 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. If the state opts not to intervene, the whistleblower shall receive between 25% and 30% of the proceeds of the action or settlement.
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 prosecution of the action.
In both cases, the whistleblower shall also receive an amount for reasonable expenses, plus reasonable attorney fees and costs.
Common forms of Iowa Medicaid fraud involve billing fraud, false documentation, off-label promotion, medical necessity fraud, stark law violations, kickbacks and false statements or certifications. The Medicaid Fraud Hotline protects the rights and privacy of health care employees and other individuals who chose to report Iowa Medicaid Fraud. Call today and secure your role as whistleblower.
What is the Iowa Statute of Limitations on Reporting Medicaid Fraud?
Under the Iowa False Claims Act (IFCA), IA Code §§ 685.1 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.
Under the IFCA, an anti-retaliation claim must be brought within three years after the date when the retaliation occurred. Other whistleblower laws may allow only 30 days after the retaliation occurs to file a claim. The Medicaid Fraud Hotline will inform you of any applicable statutes of limitations.
As cases of Iowa Medicaid fraud are increasing every year, federal and state governments lack adequate resources to discover each potential violation. Health care professionals with knowledge of fraud are the number one source the government uses to detect fraud and recover taxpayer dollars. The IFCA provides whistleblowers both financial incentive and anti-retaliation protection for those who are willing to come forward and report Iowa Medicaid Fraud.
3 Easy Steps to Help you Decide
Whether You Should Report Medicaid Fraud
Timing is critical. Whistleblower laws contain first-to-file provisions, meaning only the first whistleblower to report the fraud is eligible to collect the large cash award. In addition, statutes of limitations limit the amount of time a whistleblower has to file a claim. Call the Medicaid Fraud Hotline today. Once you make the call, you solidify your role as whistleblower. The Medicaid Fraud Hotline will then help you to determine your next steps.
Over $1 Million in Cash Awards for Tips Leading to Government Recovery