Is Your Montana Employer or other Medical Provider Guilty of Medicaid Fraud?

Montana Medicaid fraud is illegal. Montana Medicaid is a government funded health insurance program for low-income children, families, elderly, disabled and others in need. When hospitals, clinics, doctors, nurses, pharmacists or other health care professionals cheat Medicaid through overbilling, misrepresentation, kickbacks for referrals or other means, valuable tax dollars are lost and health care costs increase for everyone.

Established in 1995, the Montana Medicaid Fraud Control Unit (MFCU), a team dedicated to ensuring hard-earned Montana taxpayer dollars are used only for those in need and go only to health care providers who provide legitimate services. In 2015, the nation’s MFCU’s recovered nearly $745 million in stolen Medicaid funds through civil and criminal actions. These recoveries are largely thanks to the health care professionals who are aware of ongoing fraud in their place of work and come forward to report it.

If you have information regarding Montana Medicaid Fraud, contact the Medicaid Fraud Hotline or fill out the online report form. Timing is everything. 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.

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.

Medicaid Fraud Hotline: 888.742.7248 or Report Online

Review the Various Types of Medicaid Fraud

Reporting Montana Medicaid Fraud

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What Montana Laws Apply to Reporting Medicaid Fraud?

The Montana False Claims Act (MFCA), Mont. Code Ann. §§17-8-401 et seq., allows private citizens to file a whistleblower, ‘qui tam,’ claim on behalf of the state against wrongdoers attempting to defraud government-funded programs. The MFCA provides protections and large cash awards to whistleblowers whose information leads to government recovery.

Under the MFCA, any person causing damages in excess of $500 to a governmental entity is liable for any of the following acts:

  • knowingly presenting or causing to be presented to a governmental entity a false claim for payment or approval;
  • knowingly making, using, or causing to be made or used a false record or statement to get a false claim paid or approved by the governmental entity;
  • conspiring to defraud the governmental entity by getting a false claim allowed or paid by the governmental entity;
  • having possession, custody, or control of public property or money used or to be used by the governmental entity and knowingly delivering or causing to be delivered less property or money than the amount for which the person receives a certificate or receipt;
  • being authorized to make or deliver a document certifying receipt of property used or to be used by the governmental entity and knowingly making or delivering a receipt that falsely represents the property used or to be used;
  • knowingly buying or receiving as a pledge of an obligation or debt public property of the governmental entity from any person who may not lawfully sell or pledge the property;
  • knowingly making, using, or causing 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 governmental entity or its contractors; or
  • as a beneficiary of an inadvertent submission of a false claim to the governmental entity, subsequently discovering the falsity of the claim and failing to disclose the false claim to the governmental entity within a reasonable time after discovery of the false claim.

“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.

In a civil action brought under the MFCA, a court shall assess not less than two times and not more than three times the amount of damages that a governmental entity sustains because of the person’s act, along with costs and attorney fees, and may impose a civil penalty of up to $10,000 for each act.

Recovering stolen dollars lost to Montana Medicaid fraud is dependent on you. The impact of government resources increase significantly when physicians, nurses, EMT’s, pharmacists and others with inside information bring their knowledge to the forefront. Montana State and federal laws provide whistleblowers with powerful protections and impressive cash incentives to report fraudulent activity. Call today for a free, immediate and confidential case evaluation.

Medicaid Fraud Hotline: 888.742.7248 or Report Online

Does Montana Law Protect Those Reporting Medicaid Fraud?

Whistleblower Protections under the Montana False Claims Act

Under the Montana False Claims Act (MFCA), Mont. Code Ann. §§17-8-401 et seq., a governmental entity may not discharge, demote, suspend, threaten, harass, or deny promotion to or in any other manner discriminate against an employee in the terms and conditions of employment because of the employee’s disclosure of information to a government or law enforcement agency pertaining to a violation of the MFCA.

A governmental entity may not adopt or enforce a rule, regulation, or policy preventing an employee from disclosing information to a government or law enforcement agency with regard to or in furtherance of an investigation of a violation of the MFCA or an action brought pursuant to the MFCA.

In cases of employer retaliation, the employee may file a claim seeking:

  • reinstatement to the same position with the same seniority status, salary, benefits, and other conditions of employment that the employee would have had but for the discrimination;
  • back pay plus interest on the back pay;
  • compensation for any special damages sustained as a result of the discrimination; and
  • reasonable court or administrative proceeding costs and reasonable attorney fees.

Whistleblower Protections under the Montana Wrongful Discharge Act

Montana is unique in that it is not an “at will” employment state. But employment cannot be terminated in retaliation for refusing to violate public policy or for reporting a violation of public policy. Discharge from employment is covered under the Montana Wrongful Discharge Act (MWDA), Mont. Code Ann. §§. 39-2-901 et.seq.

During a probationary period of employment, the employment may be terminated at the will of either the employer or the employee on notice to the other for any reason or for no reason. After the probationary period (usually 3-6 months), under the MWDA, discharge is wrongful only if:

  • it was in retaliation for the employee's refusal to violate public policy or for reporting a violation of public policy;
  • it was not for good cause and the employee had completed the employer's probationary period of employment; or
  • the employer violated the express provisions of its own written personnel policy.

If an employer has committed a wrongful discharge, the employee may file a claim for lost wages and fringe benefits for a period not to exceed 4 years from the date of discharge plus interest on the lost wages and fringe benefits.

Interim earnings, including amounts the employee could have earned with reasonable diligence, must be deducted from the amount awarded for lost wages. Before interim earnings are deducted from lost wages, there must be deducted from the interim earnings any reasonable amounts expended by the employee in searching for, obtaining, or relocating to new employment.

Medicaid Fraud Hotline: 888.742.7248 or Report Online

What Cash Awards Are Available for Reporting Montana Medicaid Fraud?

Under the Montana False Claims Act (MFCA), Mont. Code Ann. §§17-8-401 et seq., if an action is filed by a governmental entity and the whistleblower elected not to enter the action as a coplaintiff, the whistleblower is entitled to between 10% and 15% of any damages and civil penalty awarded the governmental entity in the settlement or judgment.

If an action is filed by a whistleblower either as plaintiff or as coplaintiff, the whistleblower is entitled to between 15% and 50% of any damages and civil penalty awarded the governmental entity in the settlement or judgment.

A whistleblower who is a plaintiff or coplaintiff is also entitled to reasonable costs and attorney fees if the action is settled favorably for the governmental entity or the governmental entity prevails in the action.

Working together, we can reclaim stolen funds taken through fraud, waste and abuse in the Montana Medicaid program. To report suspected fraud of the Montana Medicaid Program, call the Medicaid Fraud Hotline now.

Medicaid Fraud Hotline: 888.742.7248 or Report Online

What is the Montana Statute of Limitations on Reporting Medicaid Fraud?

Under the Montana False Claims Act (MFCA), Mont. Code Ann. §§17-8-401 et seq., a complaint or civil action must be filed within 3 years after the date on which an official of the governmental entity charged with responsibility to act in the circumstances discovers the act, or more than 10 years after the date on which the act occurred, whichever occurs first.

Under the Montana Wrongful Discharge Act (MWDA), Mont. Code Ann. §§. 39-2-901 et.seq., an action must be filed within 1 year after the date of discharge.

Medicaid Fraud Hotline: 888.742.7248 or Report Online

3 Easy Steps to Help you Decide

Whether You Should Report Medicaid Fraud

If you have information regarding Montana Medicaid Fraud, contact the Medicaid Fraud Hotline or fill out the online report form. Remember, 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 apply, so call now.

Over $1 Million in Cash Awards for Tips Leading to Government Recovery
Medicaid Fraud Hotline: 888.742.7248 or Report Online