Louisiana Leads National Effort to Recover Money from Medicaid Fraud
The state of Louisiana recovered more than $124 million from Medicaid fraud payments during the last fiscal year, according to federal health officials. The state leads national efforts to recover money from Medicaid fraud.
The Federal Centers for Medicare and Medicaid Services reported that Louisiana had a fraud recovery rate of 2% of all Medicaid dollars spent. That is the highest of any state in the country. On average, states recover less than 0.6% of money from Medicaid fraud in their respective budgets.
“We take fraud and abuse of the Medicaid system very seriously in Louisiana,” state Department of Health and Hospitals Secretary Kathy Kliebert said in a news release announcing the ranking. “I am incredibly proud of the work our Program Integrity division to recover funds lost through fraudulent payments and of our ever-strengthening relationship with the attorney general’s office to go after those who seek to knowingly steal from Louisiana citizens by defrauding the Medicaid system”
Medicaid fraud is generally identified through investigations conducted by the DDH Medicaid Program Integrity division. Investigators in the department work hard to distinguish billing errors from true Medicaid fraud cases. Program staff or a Medicaid billing contractor will conduct education or training to correct cases of billing errors.
In the last fiscal year, the Program Integrity Division recouped more than $4.5 million in Medicaid fraud. The division also referred 186 groups to the attorney general’s Medicaid Fraud Control Unit for further investigation.
It Is Important to Report Medicaid Fraud
Medicare and Medicaid are government-sponsored health care programs that help the needy and the elderly cover health care costs associated with aging and disability. These programs are hugely important for people living on a fixed income, so it is incumbent upon doctors to honestly report costs both to patients and to the government.
Unfortunately, not all health care providers are honest in their assessments. Some health care providers defraud the government, in violation of the False Claims Act, by overbilling for services, double billing, or billing for services not provided. The False Claims Act imposes liability on persons or corporations that defraud the government – and this includes doctors, hospitals, and nursing homes.
The False Claims Act provides protection for those who report agencies or individuals who are defrauding the government. These lawsuits are called whistleblower, or qui tam, lawsuits. Under the qui tam provision of the False Claims Act, the relator (plaintiff) files an action on behalf of the U.S. Government. The Act allows a wide variety of people and entities to file a qui tam action. The whistleblower must have first-hand knowledge of the fraud. However, as an incentive for reporting the fraud, whistleblowers are eligible for 15-25% of any recovered damages.
The Strom Law Firm Protects Medicaid Fraud Whistleblowers in South Carolina
Common whistleblower actions include:
- Health care fraud, including Medicare and Medicaid fraud,
- defense contractor fraud, and
- other kinds of fraud.
Qui tam lawsuits have been, and continue to be, a very effective and successful tool in combating government procurement and program fraud.
If you have first-hand knowledge of government fraud occurring at your place of employment or your doctor’s office, including Medicaid fraud, the attorneys at the Strom Law Firm can help protect your rights. In order to help the government provide the best possible services, Medicare and Medicaid fraud must be reported as soon as possible. The attorneys at the Strom Law Firm understand the complexity of qui tam and whistleblower suits, and we offer free, confidential consultations to discuss the facts of your case. Contact us today.803.252.4800
