Is Your Kentucky Health Care Employer Submitting False Claims to Medicaid?
Kentucky Medicaid uses taxpayer dollars to fund quality health care services for over 1.3 million vulnerable and low-income Kentucky residents. Unfortunately, corrupt and dishonest hospitals, pharmacies, physicians, clinics and other medical professionals attempt to pocket Kentucky Medicaid funds for themselves.
These fraudsters profit from misconduct by illegally billing Kentucky Medicaid for services never provided, medically unnecessary services, illegal kickbacks and more.
The Office of the Inspector General and the Kentucky Medicaid Fraud Control Unit work together to ensure that Kentucky taxpayer dollars are spent properly and that patients receive safe, quality care.
In 2015, The Kentucky Medicaid Fraud Control Unit prosecuted 13 criminal convictions and 14 civil settlements and judgements, recovering nearly $3 million in stolen funds for the State of Kentucky.
Though the Kentucky Medicaid Fraud Control Unit continues to combat fraud, government resources are limited. It is up to Kentucky nurses, physicians, EMT’s, pharmacists and sales representatives to report any knowledge of fraud. If you feel you have knowledge of Kentucky 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 Kentucky Medicaid Fraud
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What Whistleblower Laws Govern Reporting Kentucky 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 Kentucky 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.
Kentucky Medicaid fraud wastes valuable taxpayer dollars and increases the cost of health care for everyone. The Federal False Claims Act provides whistleblowers with large cash awards for blowing the whistle on Kentucky Medicaid Fraud. Whistleblowers can also seek remedies for employer retaliation experienced after reporting fraud. Does your knowledge qualify you for a whistleblower cash award? Call today for a free, immediate and confidential case evaluation.
Are Whistleblowers Protected From Employer Retaliation After Reporting Kentucky Medicaid Fraud?
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
If your Kentucky health care employer has fired, demoted, harassed, threatened or otherwise discriminated against you for reporting Kentucky Medicaid fraud, you may be eligible to file a claim for damages. Timing is critical. Don’t hesitate to file a claim. Call the Medicaid Fraud Hotline now for a free, no-obligation case evaluation.
What Cash Awards Are Paid for Reporting Kentucky 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.
You can help safeguard Kentucky health care programs for future generations. If you suspect your Kentucky health care employer is guilty of Medicaid Fraud, you are protected by federal whistleblower laws and may be entitled to a substantial cash award for your information. Contact the Medicaid Fraud Hotline Now.
Are There Time Limits for Reporting Kentucky 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.
The government’s ability to recover stolen Kentucky Medicaid funds depends on whistleblowers coming forward. The U.S. government recovered nearly $3 billion dollars in 2014 as a result of whistleblowers reporting health care fraud. These whistleblowers were awarded over $435 million in cash for their valuable tips. Call today to learn if your information makes you eligible for a whistleblower cash award.
2 Easy Steps to Help you Decide
Whether You Should Report Medicaid Fraud
If you have information regarding Medicaid Fraud in the State of Kentucky, contact the Medicaid Fraud Hotline or fill out the online report form. Remember, you must be the FIRST to report 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