Do You Have Knowledge of Maine Medicaid Fraud?
Maine Medicaid provides health care services for over 280,000 children, adults and elderly individuals who could not afford care otherwise. The state carefully allocates hard-earned Maine tax dollars to ensure adequate funding of this valuable program.
Yet, many dishonest, corrupt health care industry professionals scheme to profit from Maine Medicaid dollars for themselves. Every Maine resident pays for these crimes through the loss of government services and resulting tax increases.
In 2015 alone, the Maine Medicaid Fraud Control Unit (MFCU) investigated over 61 reports of fraud, waste and abuse, resulting in 8 criminal convictions and 7 civil settlements and judgements, recovering over $1.2 million in stolen taxpayer dollars for the state of Maine.
These recoveries are largely due to the reports of whistleblowers – health care professionals who report knowledge of suspected fraud in their workplace.
Maine nurses, physicians, pharmacists, sales representatives and other health care professionals are in a prime position to identify cases of fraud. Because the government relies on whistleblowers to detect and report cases of fraud, the federal False Claims Act awards whistleblowers with 10% to 30% of the total government recovery.
If you have information regarding Maine Medicaid Fraud, you may be entitled to a significant cash award. Call today for a free, immediate and confidential case evaluation.
Review the Various Types of Medicaid Fraud
Reporting Maine Medicaid Fraud
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What Laws Apply to Reporting Maine 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 Maine 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.
The federal False Claims Act pays significant cash awards, often in the hundreds of thousands to millions of dollars, to those with information on Maine Medicaid fraud that leads to a successful recovery. In addition, federal whistleblower laws give anti-retaliation protections to individuals who come forward and report misconduct. If you feel you have knowledge of Maine Medicaid fraud, don’t hesitate to contact the Medicaid Fraud Hotline.
Does the Government Provide Protection For Those Reporting Maine 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
What Cash Awards Are Available for Reporting Maine 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.
When Maine Medicaid funds are wasted, stolen or abused, every Maine resident pays the price. A whistleblower’s decision to report fraud directly influences the government’s ability to prosecute these cases and stop Maine Medicaid Fraud. Do you suspect your Maine employer or other health care professional is defrauding Maine Medicaid? Help put a stop to Medicaid fraud. Call now for a free, no-obligation case evaluation.
What is the Statute of Limitations on Reporting Maine 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 regarding Medicaid Fraud in the State of Maine, 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. Help put a stop to Maine Medicaid fraud. Call now for a free, no-obligation case evaluation.
Over $1 Million in Cash Awards for Tips Leading to Government Recovery