Is Your Indiana Health Care Employer Guilty of Medicaid Fraud?

Do You Have Knowledge of Indiana Medicaid Fraud?

Far too many dishonest and corrupt health care industry professionals scheme to bypass Indiana Medicaid rules and regulations in an effort to pocket hard-earned taxpayer dollars for themselves. Every Indiana taxpayer pays for the crime of Indiana Medicaid fraud through the resulting tax increases and the loss of valuable government services.

In 2014, Indiana Medicaid Fraud Control Unit (MFCU) investigations resulted in 22 criminal convictions and 30 civil settlements and judgements, recovering over $54.5 million in stolen taxpayer dollars for the state of Indiana. Whistleblowers are credited with initiating 90% of Indiana MFCU investigations and are vital to recovering valuable Indiana funds.

Because whistleblower knowledge of Indiana Medicaid fraud is key, the Indiana False Claims Act awards whistleblowers with 10% to 30% of the total government recovery. Indiana doctors, nurses, pharmacists, medical equipment companies, dentists, nursing home caretakers, EMTs and other health care professionals who provide services to Indiana Medicaid beneficiaries are in a prime position to detect and report fraud.

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 Indiana Medicaid Fraud

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What Indiana Laws Apply to Reporting Medicaid Fraud?

The Indiana False Claims and Whistleblower Protection Act (IFCWPA), Ind. Code §§ 5-11-5.5-1 et seq., allows private citizens to file a whistleblower, or ‘qui tam,’ lawsuit on behalf of the State of Indiana and share in a percentage of any government recovery.

The IFCWPA makes it a crime to knowingly or intentionally:

• Present a false claim to the state for payment or approval;
• Make or use a false record or statement to obtain payment or approval of a false claim from the state;
• Deliver less money or property to the state than the amount recorded on the certificate or receipt the person receives from the state, with intent to defraud the state;
• Authorize issuance of a receipt without knowing that the information on the receipt is true, with intent to defraud the state;
• Receive public property as a pledge of an obligation on a debt from an employee who is not lawfully authorized to sell or pledge the property;
• Make or use a false record or statement to avoid an obligation to pay or transmit property to the state;
• Conspire with another to perform an act to defraud the state;
• Cause or induce another to perform an act to defraud the state

“Knowingly” means the person has actual knowledge of the information relating to the false claim and 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.

Individuals who violate the IFCWPA are liable to the State of Indiana for a civil penalty of at least $5,000, plus three times the amount of damages sustained by the state and the costs of the civil action brought to recover a penalty or damages.

The Medicaid-specific Indiana Medicaid False Claims and Whistleblower Protection Act (MFCWPA), Ind. Code §§ 5-11-5.7 et seq., applies specifically to claims, requests, demands, statements, records, acts, and omissions made or submitted in relation to the Indiana Medicaid program.

The Indiana MFCWPA makes it a crime to:

• knowingly present, or cause to be presented, a false or fraudulent claim for payment or approval;
• knowingly make, use, or cause to be made or used, a false record or statement that is material to a false or fraudulent claim;
• have possession, custody, or control of property or money used, or to be used, by the state, and knowingly deliver, or cause to be delivered, less than all of the money or property;
• with intent to defraud the state, authorize issuance of a receipt without knowing that the information on the receipt is true;
• knowingly buy or receive, as a pledge of an obligation or debt, public property from an employee who is not lawfully authorized to sell or pledge the property;
• knowingly make use, or cause to be made or used, a false record or statement concerning an obligation to pay or transmit money or property to the state; or conceal or knowingly and improperly avoid or decrease an obligation to pay or transmit money or property to the state;
• conspire with another person to perform a violation of the Indiana MFCWPA or;
• cause or induce another person to perform a violation of the Indiana MFCWPA.

Violators of the Indiana MFCWPA are liable to the state for a civil penalty of between $5,500 and $11,000, plus up to three times the amount of damages sustained by the state and any costs of a civil action brought to recover a penalty or damages.

Indiana whistleblower laws provide rights and protections to individuals who step forward and report misconduct. In addition, the government pays a significant cash award, often in the hundreds of thousands to millions of dollars, for reporting Indiana Medicaid fraud when an investigations leads to government recovery. If you feel you have knowledge of Indiana Medicaid fraud, don’t hesitate to contact the Medicaid Fraud Hotline.

Does Indiana Law Provide Protection For Those Reporting Medicaid Fraud?

Under the Indiana False Claims and Whistleblower Protection Act (IFCWPA), Ind. Code §§ 5-11-5.5-1 et seq., an employer may not discharge, demote, suspend, threaten, harass or otherwise discriminate against an employee because they objected to a suspected violation of the IFCWPA or they initiated, testified, assisted or participated in an investigation, an action, or a hearing involving a violation of the IFCWPA.

Likewise, the Indiana Medicaid False Claims and Whistleblower Protection Act (MFCWPA), Ind. Code §§ 5-11-5.7 et seq., prohibits employers from discharging, demoting, suspending, threatening, harassing, or otherwise discriminating against an employee, contractor, agent because of lawful acts done to:

• object to or otherwise stop an act in violation of the Indiana MFCWPA
• initiate, testify, assist, or participate in an investigation, an action, or a hearing; or
• perform any other lawful act in furtherance of other efforts to stop one or more violations of the Indiana MFCWPA

Whistleblowers Are Entitled To Remedies When Subjected to Employer Retaliation

Under both the IFCWPA and Indiana MFCWPA, whistleblowers who experience workplace retaliation are entitled to all damages essential to “make the employee whole.” These remedies include:

• Job reinstatement with the same seniority status
• Two times the amount of any back pay owed the employee
• Interest on any back pay owed the employee
• Compensation for any special damages sustained, including costs and expenses of litigation and reasonable attorneys’ fees.

What Cash Awards Are Available for Reporting Indiana Medicaid Fraud?

Under both the Indiana False Claims and Whistleblower Protection Act (IFCWPA), Ind. Code §§ 5-11-5.5-1 et seq., and the Indiana Medicaid False Claims and Whistleblower Protection Act (MFCWPA), Ind. Code §§ 5-11-5.7 et seq., the whistleblower who filed the initial complaint is entitled to the following amounts if the state prevails in the action:

• If the state chose to intervene in the action, 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 state opts not to intervene in the action, 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 calculated based upon the significance of the information provided by the whistleblower and the extent of the role the whistleblower plays in the investigation and advancing the case to litigation.

A whistleblower’s choice to come forward directly influences the government’s ability to prosecute cases of Indiana Medicaid Fraud. Indiana Medicaid provides health care services for children, adults and elderly patients who could otherwise not afford care. Indiana State carefully distributes tax dollars to ensure adequate funding of such programs. When these funds are misused, every Indiana resident suffers. Help put a stop to Indiana Medicaid fraud. Call now for a free, no-obligation case evaluation.

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

Under both the Indiana False Claims and Whistleblower Protection Act (IFCWPA), Ind. Code §§ 5-11-5.5-1 et seq., and the Indiana Medicaid False Claims and Whistleblower Protection Act (MFCWPA), Ind. Code §§ 5-11-5.7 et seq., 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 discovered or reasonably should have been discovered, 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 Indiana Medicaid False Claims and Whistleblower Protection Act (MFCWPA), Ind. Code §§ 5-11-5.7 et seq., may not be brought more than 3 years after the date the retaliation occurred.

If you have information regarding Medicaid Fraud in the State of Indiana, contact the Medicaid Fraud Hotline or fill out the online report form. Time is of the essence! 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