Is Medicaid Fraud Occurring at Your Job or Elsewhere in Washington?

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

Washington State Medicaid (also known as “Apple Health”) uses taxpayer dollars to provide quality medical care for nearly 2 million Washington elderly, disabled, adults and children in need. When deceitful, corrupt health care professionals take advantage of Washington State Medicaid for their own financial gain, all Washington residents suffer.

Blowing the whistle on Washington Medicaid fraud keeps the cost of health care down for everyone, ensures patient safety and encourages corporate integrity. Nearly 43% of all fraud in our nation is discovered by whistleblowers coming forward. Yet the fear of employer retaliation keeps many individuals from reporting knowledge of suspected Washington Medicaid fraud.

Inaction in response to fear and intimidation is tragic. It not only indirectly supports the employer’s illegal conduct, but also puts innocent taxpayers at risk for ill-managed patient care and unaffordable health care costs. Washington law provides powerful protections against employer retaliation in response to reporting Washington Medicaid fraud and also pays large cash whistleblower awards to individuals who choose to come forward.

If you feel that your Washington health care employer has been submitting false or fraudulent claims to Medicaid, they most likely are. Whether the conduct you suspect is illegal or merely on the verge of violating the law, reporting your suspicions to the Medicaid Fraud Hotline is the smartest move you can make. 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 Washington Medicaid Fraud

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What Washington Laws Apply to Reporting Medicaid Fraud?

The Washington State Medicaid Fraud False Claims Act (WMFCA), Wash. Rev. Code Ann. §§ 74.66.005 et seq., allows individuals with knowledge of Washington Medicaid Fraud to file a claim on behalf of the State of Washington and receive a share of any government recovery.

A person violates the WMFCA when they:

• 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;
• Conspire to commit a violation of the WMFCA;
• Have possession of government money and knowingly deliver less than all of that money;
• Intending to defraud the government, make or deliver a receipt without completely knowing that the information on the receipt is true;
• Knowingly make a false record or statement regarding an obligation to pay the government, or knowingly conceal, avoid or decrease an obligation to pay the government.

"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. "Knowing" and "knowingly" do not require proof of specific intent to defraud.

Any person who violates the WMFCA is liable for a civil penalty of between $5,500 and $11,000, plus three times the amount of damages the government entity sustains because of the violation.

If you feel you have knowledge of Washington Medicaid fraud, call the Medicaid Fraud Hotline now. Fast action is imperative. Requirements for “original and non-public information” make only the first person to report knowledge of fraud eligible for a whistleblower cash reward.

Does Washington Law Provide Protection For Those Reporting Medicaid Fraud?

Under the Washington State Medicaid Fraud False Claims Act (WMFCA), Wash. Rev. Code Ann. §§ 74.66.005 et seq., no employer may discharge, demote, suspend, threaten, harass or in any other manner discriminate against an employee because of lawful acts done in furtherance of an action or other efforts to stop a violation of the WMFCA.

Should retaliation occur, the employee may file a claim seeking relief, including:

• reinstatement with the same seniority status that 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, including litigation costs and reasonable attorneys' fees

Under the Washington State Employee Whistleblower Protection Act, Wash. Rev. Code Ann. §§ 42.40.010 et seq., Washington state employees have a right to disclose an employer’s improper government actions without interference from the employer.

A state employer or employee may not use their official authority to intimidate, threaten, coerce, command or influence any individual for the purpose of interfering with the right of the individual to disclose information concerning improper governmental action.

The whistleblower must act in good faith when reporting improper government action. "Improper governmental action" means any action that is:

• a gross waste of public funds or resources
• in violation of federal or state law or rule
• of substantial and specific danger to the public health or safety, or
• gross mismanagement

“Interference” includes an employer or employee threatening, taking, recommending, processing or approving any personnel action including change of duties and office location, reassignment, reinstatement, restoration, reemployment, performance evaluation, material changes in pay, provision of training or benefits, tolerance of a hostile work environment, or other disciplinary action.

Any whistleblower subjected to workplace reprisal or retaliatory action is presumed to have a cause of action for remedies.

“Reprisal or retaliatory action" means (but is not limited to) denial of adequate staff to perform duties, frequent staff changes, frequent and undesirable office changes, refusal to assign meaningful work, unwarranted and unsubstantiated letters of reprimand or unsatisfactory performance evaluations, demotion, reduction in pay, denial of promotion, suspension, dismissal, denial of employment, encouraging hostile treatment, changing the employee's workplace location, changing the basic job nature, enforcing any nondisclosure policy or any other action that is inconsistent compared to actions taken before the employee disclosed the misconduct.

An individual with information on Washington Medicaid fraud must act fast. If the information is reported by someone else, leaked to the public or doesn’t meet the statute of limitations, eligibility for the whistleblower cash award is lost. Since months to years of investigation and preparation can be required before a whistleblower case gets underway, it is crucial that health care employees report Medicaid fraud as soon as possible.

What Cash Awards Are Available for Reporting Washington Medicaid Fraud?

Under the Washington State Medicaid Fraud False Claims Act (WMFCA), Wash. Rev. Code Ann. §§ 74.66.005 et seq., if the attorney general proceeds with a whistleblower action, the whistleblower is entitled to between 15% and 25% of any government recovery, depending upon the extent to which the whistleblower contributed to the prosecution. If the attorney general does not intervene in the whistleblower action, the whistleblower may collect between 25% and 30% of the government recovery.

The whistleblower is also entitled to receive an amount for reasonable expenses the court finds were necessarily incurred, plus reasonable attorneys' fees and costs.

If you feel that your employer has taken retaliatory action against you for reporting (or intending to report) Medicaid fraud, call the Medicaid Fraud Hotline for a free, confidential consultation to discuss your options and potential remedies under Washington and Federal law.

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

There is no statute of limitations for whistleblower claims brought under the Washington State Medicaid Fraud False Claims Act (WMFCA), Wash. Rev. Code Ann. §§ 74.66.005 et seq.

Claims under the anti-retaliation provision of the Washington State Medicaid Fraud False Claims Act (WMFCA), Wash. Rev. Code Ann. §§ 74.66.005 et seq., must be brought within 3 years of the date when the retaliation occurred.

Under the Washington State Employee Whistleblower Protection Act, Wash. Rev. Code Ann. §§ 42.40.010 et seq., an assertion of improper governmental action must be provided within 1 year of the occurrence of the asserted improper governmental action.

Act now to secure your position as whistleblower and begin building your case. Contact the Medicaid Fraud Hotline for a free, fully confidential case evaluation. We will discuss your options and help ensure you are taking the appropriate steps to maximize your claim.

Over $1 Million in Cash Awards for Tips Leading to Government Recovery