Is Your Oklahoma Employer or other Medical Provider Guilty of Medicaid Fraud?
Oklahoma Medicaid provides quality, affordable medical care to low income children, adults and elderly. This government health care program is funded by the hard-earned dollars of Oklahoma taxpayers. When dishonest, corrupt health care professionals, clinics and hospitals scheme to steal from Medicaid, all Oklahomans suffer.
In 2015 alone, the Oklahoma Medicaid Fraud Control Unit (MFCU) recovered over $7 million in stolen Oklahoma Medicaid funds. Whistleblowers – i.e. physicians, nurses, pharmacists, sales representatives and other health care professionals who report knowledge of Oklahoma Medicaid fraud - are a critical resource in these recoveries. Federal and state law provide large cash incentives for coming forward with knowledge of fraud and remedies for any employer retaliation.
Common forms of Oklahoma Medicaid fraud involve overbilling, false documentation, medical necessity fraud, off-label promotion, kickbacks and Stark Law violations. The Medicaid Fraud Hotline protects the rights and privacy of health care employees and other individuals who chose to report Oklahoma Medicaid Fraud. Call today and secure your role as whistleblower.
Review the Various Types of Medicaid Fraud
Reporting Oklahoma Medicaid Fraud
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What Oklahoma Laws Apply to Reporting Medicaid Fraud?
The Oklahoma Medicaid False Claims Act (OMFCA), Okla. Stat. 63, §§5053 et seq., allows those with knowledge on fraud against Oklahoma Medicaid to file a “qui tam,” whistleblower lawsuit on behalf of the state. The OMFCA awards whistleblowers with a percentage of any government recovery and provides remedies for any employer retaliation.
A violation of the OMFCA occurs any time a person:
- Knowingly presents, or causes to be presented, to an officer or employee of the State of Oklahoma, 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 state;
- Conspires to defraud the state 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 state and, intending to defraud the state 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;
- Is authorized to make or deliver a document certifying receipt of 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, 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 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.
Penalties for violating the OMFCA include a civil penalty of between $5,000 and $10,000 per false claim, plus three times the amount of damages the state sustains because of the act of that person.
Corrupt hospitals, physicians, clinics, nurses, home health agencies, medical transportation companies or pharmacies may scheme to steal tax dollars from government health care programs by submitting false or fraudulent claims to Oklahoma Medicaid. If you suspect a medical professional is committing fraud against Oklahoma Medicaid, report your information now. We guarantee your privacy. Contacting the Medicaid Fraud Hotline does not obligate you to pursue a case.
Does Oklahoma Law Provide Protection For Those Reporting Medicaid Fraud?
Whistleblower Protections under the Oklahoma Medicaid False Claims Act
Under the Oklahoma Medicaid False Claims Act (OMFCA), Okla. Stat. 63, §§5053 et seq., no employer may discharge, demote, suspend, threaten, harass or in any other manner discriminate against his or her employee because of lawful acts done in furtherance of an action under the OMFCA, including investigation for, initiation of, testimony for, or assistance in an action filed or to be filed.
Any employee experiencing employer retaliation in response to reporting Oklahoma Medicaid fraud or participating in an action shall be entitled to all relief necessary to make the employee whole, including:
- job 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 attorney fees.
Whistleblower Protections under the Oklahoma Whistleblower Act
The Oklahoma Whistleblower Act (OWA), Okla. Stat. 74, § 840-2.5, is in place to encourage and protect the reporting of wrongful governmental activities and to deter retaliation against state employees for reporting those activities. No conviction is required to afford protection for any employee under the OWA.
Under the OWA, no officer or employee of any state agency shall prohibit or take disciplinary action against employees of such agency for:
- Disclosing public information to correct what the employee reasonably believes evidences a violation of the Oklahoma Constitution or law or a rule promulgated pursuant to law;
- Reporting a violation of the Oklahoma Constitution, state or federal law, rule or policy; mismanagement; a gross waste of public funds; an abuse of authority; or a substantial and specific danger to public health or safety;
- Discussing the operations and functions of the agency, either specifically or generally, with the Governor, members of the Legislature, the print or electronic media or other persons in a position to investigate or initiate corrective action; or
- Taking any of the above actions without giving prior notice to the employee's supervisor or anyone else in the employee's chain of command.
Under the OWA, "disciplinary action" means any direct or indirect form of discipline, any dismissal, demotion, transfer, reassignment, suspension, reprimand, admonishment, warning of possible dismissal, reduction in force, reduction in rank, reduction in status, or withholding of work.
Whether you just suspect Medicaid fraud in your Oklahoma workplace, or you have absolute evidence of Oklahoma Medicaid fraud, don’t hesitate to contact the Medicaid Fraud Hotline. The State of Oklahoma depends individuals with integrity and honesty in Oklahoma’s health care industry. Federal and state laws provide significant whistleblower cash rewards and protection from employer retaliation for those who report Oklahoma Medicaid fraud.
What Cash Awards Are Available for Reporting Oklahoma Medicaid Fraud?
Under the Oklahoma Medicaid False Claims Act (OMFCA), Okla. Stat. 63, §§5053 et seq., if the state proceeds with an action brought by a whistleblower, the whistleblower is entitled to receive between 15% and 25% of the proceeds of the action or settlement of the claim. 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 both cases, the whistleblower shall also receive an amount for reasonable expenses which the court finds to have been necessarily incurred, plus reasonable attorney fees and costs. The full amount awarded depends upon the extent to which the person substantially contributed to the prosecution of the action.
What is the Oklahoma Statute of Limitations on Reporting Medicaid Fraud?
Under the Oklahoma Medicaid False Claims Act (OMFCA), Okla. Stat. 63, §§5053 et seq., a civil action must be brought:
- Within 6 years after the date on which the violation of the Oklahoma Medicaid False Claims Act is committed; or
- Within 3 years after the date when facts material to the right of action are known or reasonably should have been known by the official of the State of Oklahoma charged with responsibility to act, but
- In no event more than 10 years after the date on which the violation is committed, whichever occurs last.
Don’t delay. Solidify your role as whistleblower or you may forfeit your cash reward. Whistleblower laws contain first-to-file provisions, meaning only the first whistleblower to report the fraud is eligible to collect the cash award. In addition, statutes of limitations limit the amount of time a whistleblower has to file a claim. Once you make the call, you solidify your role as whistleblower. Call the Medicaid Fraud Hotline today.
3 Easy Steps to Help you Decide
Whether You Should Report Medicaid Fraud
Federal and state whistleblower laws and False Claims Acts are the primary weapons our government uses to combat Oklahoma Medicaid fraud. If you suspect your Oklahoma employer, other agency or medical provider is acting to defraud the Oklahoma Medicaid program, contact the Medicaid Fraud Hotline now for a no-cost, completely confidential case evaluation.
Over $1 Million in Cash Awards for Tips Leading to Government Recovery