CCH® Healthcare Compliance — 8/20/08

Six state false claims acts fall short of DRA requirements

The Office of Inspector General (OIG) issued letters to state officials in Florida, Louisiana, Michigan, New Hampshire, New Mexico and Oklahoma notifying them that their false claims statutes failed to satisfy the requirements of the federal Deficit Reduction Act of 2005 (DRA). Statutes submitted for review by California, Georgia, Indiana and Rhode Island, however, did satisfy the DRA’s requirements, making those states eligible for a 10-percent increase in their share of Medicaid false claim recoveries.

The DRA provides a financial incentive for states to enact laws that establish liability for those who submit false or fraudulent claims to the state Medicaid program. States must enact statutes at least as stringent as the federal False Claims Act (FCA) to qualify for the incentive

Qui Tam problems. Under the FCA, individuals can bring suit on the government’s behalf and retain a portion of any settlement or award the suit yields. In its review letters, OIG determined that the six noncompliant state statutes were not as effective in rewarding and facilitating qui tam actions as the federal act. In Louisiana, for example, the state law imposes a shorter statute of limitations on qui tam actions than the federal FCA. The New Hampshire false claims act did not meet the DRA requirements because it does not allow a relator to proceed with a qui tam action if the state declines to proceed. Under the FCA, a relator may proceed with a qui tam action - and collect a percentage of any award - even if the government elects not to join the suit.

States that failed to meet the DRA’s guidelines were invited to notify OIG if their false claims statutes were amended and to submit them for reconsideration. OIG has previously approved false claims act in eight other states -Hawaii, Illinois, Massachusetts, Nevada, New York, Tennessee, Texas and Virginia.

OIG Review Letters, July 24, 2008.

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