Is Your Minnesota Health Care Employer Guilty of Medicaid Fraud?

Is Your Minnesota Employer Or Medical Provider Submitting False Or Fraudulent Claims To Medicaid?

False billing and other fraudulent health care schemes account for up to 10% of Minnesota Medicaid claims each year, meaning fraudsters pocket billions in Minnesota taxpayer dollars each year – dollars meant to provide quality health care to low income children, adults and elderly. Illegal use of Minnesota Medicaid funds results in an increase in health care for every Minnesota resident.

The Minnesota Medicaid Fraud Control Unit (MFCU) is in place to investigate fraud, waste and abuse of Minnesota Medicaid funds and recover improper reimbursements for the State. In 2015, the MFCU recovered nearly $2 million in stolen Medicaid funds and achieved 19 criminal convictions. Because resources are limited, discovery is largely dependent on nurses, EMT’s, bookkeepers, physicians, pharmacists and sales representatives who have first-hand knowledge of billing policies and practices and products and services rendered.

Don’t put off your report. Only the first to report a False Claims Act violation is eligible to collect a whistleblower cash award. If you have information relating to Minnesota Medicaid Fraud, contact the Medicaid Fraud Hotline or fill out the online report form. Secure your eligibility now by calling the Medicaid Fraud Hotline and receive an immediate and confidential, no-obligation case evaluation.

Review the Various Types of Medicaid Fraud

Reporting Minnesota Medicaid Fraud

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What Are The Minnesota Laws Covering Medicaid Fraud Reporting?

Under the Minnesota False Claims Act (MFCA), Minn. Stat. §§15C.01 et seq., private citizens are able to file whistleblower, ‘qui tam’ claims on behalf of the state against those suspected of submitting false claims to Minnesota Medicaid. The MFCA provides protections against employer retaliation in response to reporting fraud and provides substantial cash awards for information leading to successful recovery of stolen funds.

Any person who commits any of the following acts is in violation of the MFCA:

• knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval;
• knowingly makes or uses, or causes to be made or used, a false record or statement material to a false or fraudulent claim;
• knowingly conspires to commit a violation of the MFCA;
• has possession, custody, or control of property or money used, or to be used, by the state 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 for money or property used, or to be used, by the state and, intending to defraud the state, 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 state who lawfully may not sell or pledge the property; or
• knowingly makes or 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 state, or knowingly conceals or knowingly and improperly avoids or decreases an obligation to pay or transmit money or property to the state.

"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, but in no case is a person who acts merely negligently, inadvertently, or mistakenly deemed to have acted knowingly.

Those violating the MFCA are liable to the state for a civil penalty of between $5,500 and $11,000 per false or fraudulent claim, plus three times the amount of damages that the state sustains because of the act, and costs of the civil action brought to recover any penalty or damages.

Minnesota Medicaid fraud puts patients at risk and raises health care costs for everyone. If you have knowledge of medically unnecessary service provision, inappropriate billing, ineligible patient coverage, physician kickbacks, document falsification or other fraudulent activity that results in false claims submitted to Minnesota Medicaid, you are protected by law and may be entitled to a substantial cash award. Putting a stop to Minnesota Medicaid fraud is vital to the future of our nation’s health care programs. Contact the Medicaid Fraud Hotline Today.

Does Minnesota Law Protect Those Who Report Medicaid Fraud?

Whistleblower Protections under the Minnesota False Claims Act

Under the Minnesota False Claims Act (MFCA), Minn. Stat. §§15C.01 et seq., an employee, contractor, or agent is entitled to all relief necessary to make them whole if they are discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against because of lawful acts done in furtherance of an action or other efforts to stop one or more violations of the MFCA.

Relief under anti-retaliation provision of the MFCA shall include:

• reinstatement with the same seniority status that the employee, contractor, or agent 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 attorney fees.

Whistleblower Protections under the Minnesota Whistleblower Law

Under the Minnesota Whistleblower Law, Minn. Stat. § 181.932, an employer may not discharge, discipline, threaten, otherwise discriminate against, or penalize an employee regarding the employee's compensation, terms, conditions, location, or privileges of employment because:

• the employee, or a person acting on behalf of an employee, in good faith, reports a violation, suspected violation, or planned violation of any federal or state law or common law or rule adopted pursuant to law to an employer or to any governmental body or law enforcement official;
• the employee is requested by a public body or office to participate in an investigation, hearing, inquiry;
• the employee refuses an employer's order to perform an action that the employee has an objective basis in fact to believe violates any state or federal law or rule or regulation adopted pursuant to law, and the employee informs the employer that the order is being refused for that reason;
• the employee, in good faith, reports a situation in which the quality of health care services provided by a health care facility, organization, or health care provider violates a standard established by federal or state law or a professionally recognized national clinical or ethical standard and potentially places the public at risk of harm;
• a public employee communicates the findings of a scientific or technical study that the employee, in good faith, believes to be truthful and accurate, including reports to a governmental body or law enforcement official; or
• an employee in the classified service of state government communicates information that the employee, in good faith, believes to be truthful and accurate, and that relates to state services, including the financing of state services, to a legislator or the legislative auditor or a constitutional officer.

What Cash Award Amount Is Paid To Minnesota Medicaid Fraud Whistleblowers?

Under the Minnesota False Claims Act (MFCA), Minn. Stat. §§15C.01 et seq., if the prosecuting attorney intervenes in an action, the whistleblower is entitled to receive between 15% and 25% of any recovery. If the prosecuting attorney does not intervene in the action, the person is entitled to receive between 25% and 30% of any recovery. If the prosecuting attorney does not intervene in the action at the outset but subsequently intervenes, the person is entitled to receive between 15% and 30% of any recovery.

The court will also award the prevailing whistleblower with reasonable costs, reasonable attorney fees, and the reasonable fees of expert consultants and expert witnesses. The court determines the exact amount awarded to the whistleblower depending on the extent to which the whistleblower contributed to the conduct of the action.

State and federal False Claims Acts provide Minnesota whistleblowers with big financial incentives and powerful protections for choosing to come forward and report fraud, waste and abuse of Minnesota Medicaid funds. If you suspect Medicaid Fraud is occurring within your place of business or other Minnesota health care facility, you may be entitled to a significant cash award. Call today for a free, immediate and confidential case evaluation.

Are There Time Limits On Reporting Minnesota Medicaid Fraud?

A whistleblower lawsuit Minnesota False Claims Act (MFCA), Minn. Stat. §§15C.01 et seq., must be brought:

• within 6 years after the date on which the violation is committed, or
• within 3 years after the date of discovery of the fraudulent activity by the prosecuting attorney, whichever occurs later, and
• no longer than 10 years after the date on which the violation is committed.

A civil action under the anti-retaliation provision of the MFCA must be brought within three years after the date when the retaliation occurred.

In 2014, our nation’s whistleblowers received a collective $435 million in whistleblower cash awards for aiding in the recovery of $3 billion in stolen taxpayer dollars. Successful recovery of stolen Minnesota Medicaid funds is dependent on whistleblowers coming forward to report their information. Don’t wait to make your report. Learn your rights and secure your role as whistleblower. Call the Medicaid Fraud Hotline Now.

Whistleblowers Paid Over $1 Million Cash for Tips Leading to Minnesota Recovery