Is Your New Hampshire Employer or other Medical Provider Guilty of Medicaid Fraud?
Hospitals, clinics, pharmacists and other medical professionals who defraud New Hampshire Medicaid steal from New Hampshire taxpayers and take quality health care services out of the hands of children, adults and elderly who rely on New Hampshire Medicaid for their health care needs.
New Hampshire’s Medicaid Fraud Control Unit is dedicated to protecting affordable health care resources for the over 130,000 Medicaid beneficiaries and prosecutes those who attempt to steal taxpayer dollars and compromise New Hampshire health care programs. In 2015 alone, New Hampshire’s Medicaid Fraud Control Unit obtained 13 civil settlements or judgements – recovering nearly $487,000 in stolen state health care funds.
If you have information regarding 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 New Hampshire Medicaid Fraud
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What New Hampshire Laws Apply to Reporting Medicaid Fraud?
The New Hampshire False Claims Act (NHFCA), N.H. Rev. Stat. Ann. §§167:61-b et seq., allows private citizens with knowledge of persons or agencies making efforts to fraudulently obtain or bypass payment of state funds to file a claim on behalf of the state. Under the NHFCA, “fraud” is defined as the “intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unamortized benefit to himself or some other person.”
Under the NHFCA, any person shall be liable to the state who:
- Knowingly presents, or causes to be presented, to an officer or employee of the department, a false or fraudulent claim for payment or approval.
- Knowingly makes, uses, or causes to be made or used, a false record or statement to get a false or fraudulent claim paid or approved by the department.
- Conspires to defraud the department by getting a false or fraudulent claim allowed or paid.
- Has possession, custody, or control of property or money used, or to be used, by the department and, intending to defraud the department or willfully to conceal the property, delivers, or causes to be delivered, less property than the amount for which the person receives a certificate or receipt.
- Knowingly makes, uses, or causes 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 department.
- Is a beneficiary of an inadvertent submission of a false claim to the department, who subsequently discovers the falsity of the claim, and fails to disclose the false claim to the department within a reasonable time after discovery of the false claim.
"Knowing'' and "knowingly'' means 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 for an act to be knowing.
Penalties for violating the NHFCA include a civil penalty of between $5,000 and $10,000 per violation, plus three times the amount of damages that the state sustains because of the violation and costs and attorneys' fees arising from any civil action brought to recover the penalty or damages.
Putting a stop to New Hampshire Medicaid fraud relies heavily on individuals working in the health care industry. Whistleblowers like doctors, pharmacists, bookkeepers, sales representatives, nurses and other insiders have unique access to evidence regarding fraud, waste and abuse of government funds. New Hampshire State and federal laws provide large cash awards and powerful protections against employer retaliation to those who chose to report fraud.
Does New Hampshire Law Protect Those Reporting Medicaid Fraud?
Whistleblower Protections under the New Hampshire False Claims Act
Under the New Hampshire False Claims Act (NHFCA), N.H. Rev. Stat. Ann. §§167:61-b et seq., any employee who is discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against by his or her employer because of lawful acts done by the employee on behalf of the employee, including investigation for, initiation of, testimony for, or assistance in an action filed or to be filed under the NHFCA, shall be entitled to all relief necessary to make the employee whole.
Such relief shall include:
- reinstatement with the same seniority status such employee would have had but for the discrimination,
- two times the amount of back pay,
- interest on the back pay, and
- compensation for any special damages sustained as a result of the discrimination, including litigation costs and reasonable attorneys' fees.
Whistleblower Protections under the New Hampshire Whistleblower Protection Act
The New Hampshire Whistleblower Protection Act (NHWPA), N.H. Rev. Stat. Ann. Ch. 275-E, allows employees to file a claim for remedies against an employer who retaliates in response to the employer’s reporting suspected knowledge of fraud against the government.
Under the NHWPA, no employer shall harass, abuse, intimidate, discharge, threaten, or otherwise discriminate against any employee regarding compensation, terms, conditions, location, or privileges of employment because:
- The employee, in good faith, reports or causes to be reported, what the employee has reasonable cause to believe is a violation of any law or rule adopted under the laws of this state; or
- The employee objects to or refuses to participate in any activity that the employee, in good faith, believes is a violation of the law; or
- The employee, in good faith, participates in an investigation, hearing, or inquiry conducted by any governmental entity which concerns allegations that the employer has violated any law or rule adopted under the laws of this state.
Remedies include job reinstatement and back pay, as well as reasonable attorney fees and costs.
In addition, no employer shall discharge, threaten or otherwise discriminate against any employee because the employee has refused to execute a directive which in fact violates any law or rule adopted under the laws of this state.
Any employee who alleges a violation of these rights who has first made a reasonable effort to maintain or restore such employee's rights through any grievance procedure or similar process available at such employee's place of employment, may file a claim for reinstatement of the employee, the payment of back pay, fringe benefits and seniority rights, any appropriate injunctive relief, or any combination of these remedies.
Whistleblower health care fraud cases have recovered over $15.1 billion for the U.S. Department of Justice has recovered over $15.1 billion in health care fraud in the last six years. If you suspect your New Hampshire employer or other medical provider is committing New Hampshire Medicaid fraud, report it now. You may be entitled to a significant cash award. Call today for a free, immediate and confidential case evaluation.
What Cash Awards Are Available for Reporting New Hampshire Medicaid Fraud?
Under the New Hampshire False Claims Act (NHFCA), N.H. Rev. Stat. Ann. §§167:61-b et seq., 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, depending upon the extent to which the whistleblower substantially contributed to the prosecution of the action.
If the state does not proceed with an action, the whistleblower shall receive an amount between 25% and 30% of the proceeds of the action or settlement in an amount that the court decides is reasonable for collecting the civil penalty and damages.
In both cases, the whistleblower shall also receive an amount for reasonable expenses that the court finds to have been necessarily incurred, plus reasonable attorneys' fees and costs.
Help recover stolen funds taken through fraud, waste and abuse in the New Hampshire Medicaid program. To report suspected fraud of the New Hampshire Medicaid Program, call the Medicaid Fraud Hotline now.
What is the New Hampshire Statute of Limitations on Reporting Medicaid Fraud?
Under the New Hampshire False Claims Act (NHFCA), N.H. Rev. Stat. Ann. §§167:61-b et seq., an action for false claims under the NHFCA may not be brought:
- More than 6 years after the date on which the violation is committed; or
- More than 3 years after the date when facts material to the right of action are known or reasonably should have been known by the official within the office of the attorney general charged with responsibility to act in the circumstances,
- But in no event more than 10 years after the date on which the violation is committed, whichever occurs last.
Under the New Hampshire Whistleblower’s Protection Act (NHWPA), N.H. Rev. Stat. Ann. Ch. 275-E, an aggrieved employee may bring a civil suit within 3 years of the alleged employer retaliation.
3 Easy Steps to Help you Decide
Whether You Should Report Medicaid Fraud
If you have information regarding New Hampshire Medicaid Fraud, contact the Medicaid Fraud Hotline or fill out the online report form. Timing is critical - you must be the first to report the knowledge to secure your role as whistleblower and be eligible for a cash award. Statutes of limitations may limit your time to file a claim.
Over $1 Million in Cash Awards for Tips Leading to Government Recovery