Is Your Washington DC Health Care Employer Participating In Medicaid Billing Fraud?
Washington DC health care professionals who exploit Washington DC Medicaid for their own financial gain steal valuable taxpayer dollars from District funds designated for elderly, disabled, children and adults in need. False statements, misrepresentation, kickbacks and billing for medically unnecessary costs are just a handful of Washington DC Medicaid fraud schemes that District health care providers or suppliers use to try to cheat Washington DC Medicaid.
Stealing from Washington DC Medicaid causes a devastating increase in overall healthcare costs. When providers make decisions based on financial gain over patient need, patient care suffers. In 2015, the Washington DC Medicaid Fraud Control Unit prosecuted 30 criminal convictions and 10 civil settlements and judgements, recovering nearly $2 million in stolen Washington D.C. Medicaid funds. A large portion of these recoveries was successful thanks to the reports of whistleblowers – Washington DC health care professionals who come forward to report knowledge of Washington DC Medicaid fraud.
Do you suspect your Washington DC health care employer is guilty of Washington DC Medicaid fraud? Federal and Washington DC law provides powerful protections and large cash incentives for whistleblowers willing to report original knowledge of illegal activity. Find out if your information on qualifies you for a whistleblower cash award. Call now for a free, instant and confidential case evaluation.
Review the Various Types of Medicaid Fraud
Reporting Washington D.C. Medicaid Fraud
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What Washington DC Whistleblower Laws Cover Reporting Medicaid Fraud?
The District of Columbia False Claims Act (DCFCA), DC Code §§ 2-381.01 et seq., allows those with knowledge of Washington DC Medicaid fraud to file a claim on behalf of the District and share in any government recovery.
The DCFCA makes it illegal for a person to:
- knowingly present a false or fraudulent claim for payment or approval;
- knowingly make a false record or statement material to a false or fraudulent claim;
- have possession of money used by the District and knowingly deliver less than all of that money;
- intending to defraud the District, delivers a receipt without completely knowing that the information on the receipt is true;
- knowingly make a false record or statement material to an obligation to pay or transmit money to the District, or knowingly conceal, avoid or decreases an obligation to pay or transmit money to the District;
- conspire to commit a violation of the DCFCA;
- discover the falsity of a claim and fail to disclose the false or fraudulent claim to the District; or
- knowingly fail to repay an inadvertent payment or overpayment to the District.
"Knowing" or "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. The terms "knowing" and "knowingly" do not require proof of specific intent to defraud.
Violation of the DCFCA is punishable by a penalty of three times the amount of damages the District sustains because of the violation, plus the costs of a civil action brought to recover penalties or damages and a civil penalty of between $5,500 and $11,000 for each false or fraudulent claim.
Whistleblowers are our nation’s first line of defense in combatting Washington DC Medicaid fraud. Health care professionals and others with knowledge of Washington DC Medicaid fraud may be eligible for a substantial cash reward and are encouraged to connect with the Medicaid Fraud Hotline now for a free, no-obligation case evaluation.
What Protections Does Washington DC Law Provide For Medicaid Fraud Whistleblowers?
Under the District of Columbia False Claims Act (DCFCA), DC Code §§ 2-381.01 et seq., an employer may not discharge, demote, suspend, threaten, harass or in any other manner discriminate against an employee because of lawful acts done by the employee in furtherance of an action or other efforts to stop a violation of the DCFCA.
An employee or contractor whose employer retaliates against them in response to reporting Washington DC Medicaid fraud is entitled to all relief necessary to make that employee whole, including:
- reinstatement with the same seniority status that the employee would have had but for the discrimination
- two times the amount of back pay
- interest on the back pay
- compensation for any special damages sustained as a result of the discrimination
- litigation costs and reasonable attorneys' fees
The Washington DC Whistleblower Protection Act, D.C. Code §§ 1-615.51 et seq., is in place to ensure employees of the District government are free to report Washington DC Medicaid fraud without fear of retaliation or reprisal. Prohibited action includes but not limited to termination, demotion, suspension, reprimand, involuntary transfer, reassignment, referral for psychiatric or psychological counseling, failure to promote or hire or take other favorable personnel action or retaliating in any other manner against an employee because that employee makes a protected disclosure or refuses to comply with an illegal order.
“Protected disclosure” includes any disclosure of information by an employee that the employee reasonably believes evidences gross mismanagement, gross misuse or waste of public resources or funds, abuse of authority in connection with the administration of a public program or the execution of a public contract, a violation of a federal, state, or local law, rule, or regulation or of a term of a contract, or a substantial and specific danger to the public health and safety.
District employees may bring a civil action seeking relief and damages against any District employee, supervisor or official having personal involvement in the retaliation. Relief may include an injunction, reinstatement to the same position or an equivalent position, reinstatement of the employee’s seniority rights, restoration of lost benefits, back pay and interest on back pay, compensatory damages and reasonable costs and attorney fees.
Up to 10% of all Medicaid claims submitted by Washington DC Medicaid health care providers are excessive or fraudulent. This is precisely why the government is willing to pay substantial cash awards to whistleblowers for exposing misconduct. Contact the Medicaid Fraud Hotline Now to learn whether you have a case and are eligible for a cash award.
What Cash Award Amounts Are Offered for Reporting Washington DC Medicaid Fraud?
Under the District of Columbia False Claims Act (DCFCA), DC Code §§ 2-381.01 et seq., if the District proceeds with a whistleblower action, the whistleblower is entitled to receive between 15% and 25% of the proceeds of the action or settlement of the claim, depending upon the extent to which the whistleblower substantially contributed to the prosecution of the action. If the District does not intervene in the whistleblower action, the whistleblower is entitled to between 25% and 30% of the proceeds.
Any whistleblower receiving a payment is also entitled to receive an amount for reasonable expenses necessarily incurred, plus reasonable attorney's fees and costs.
If you have knowledge of Washington DC Medicaid fraud, contact the Medicaid Fraud Hotline or fill out the online report form. Learn about your rights as a whistleblower and discover if you are entitled to a cash award.
What is the Statute of Limitations on Reporting Washington DC Medicaid Fraud?
Under the District of Columbia False Claims Act (DCFCA), DC Code §§ 2-381.01 et seq., a whistleblower claim must be brought:
- within 6 years of the date on which the violation is committed, or
- within 3 years of the date when facts material to the right of action are known or reasonably should have been known, but
- in no event more than 10 years after the date on which the violation is committed, whichever occurs last.
Under the anti-retaliation provision of the District of Columbia False Claims Act (DCFCA), DC Code §§ 2-381.01 et seq., a civil action must be brought within 3 years of the date the retaliation occurred.
Under the Washington DC Whistleblower Protection Act, D.C. Code §§ 1-615.51 et seq., a civil action must be filed within 3 years of retaliation or within 1 year after the employee first becomes aware of the retaliation, whichever occurs first.
3 Easy Steps to Help you Decide
Whether You Should Report Medicaid Fraud
If you have knowledge of Washington DC Medicaid fraud, contact the Medicaid Fraud Hotline or fill out the online report form. Act fast. First to file provisions mean only the first to report an incident is eligible for a cash award. Statutes of limitations may apply.
Huge Cash Rewards Paid for Reporting Washington DC Medicaid Fraud