Governor Signs Medicaid Whistleblower Protection Legislation, Reports Michigan Attorney General Mike Cox

6 January 2006

LANSING, Mich., Jan. 3 -- Attorney General Mike Cox applauded the Governor today for signing the Medicaid Whistleblower Protection legislation into law. The legislation was unveiled in March 2005 by Cox and the bill's sponsor, Rep. David Law (R-Commerce Township) as part of the Attorney General's ongoing fight against Medicaid fraud.

"Medicaid fraud costs the people of Michigan millions each year and takes from the people who need and deserve the help that Medicaid provides," said Cox. "This law will enhance my office's ability to discover and prosecute Medicaid fraud."

Almost 20 percent of Michigan's annual budget is dedicated to Medicaid. National studies indicate that between three and ten percent of a state's Medicaid costs are fraudulent claims. For Michigan, this equates to anywhere between $225 million - $800 million. In addition, the successful prosecution of Medicaid fraud will result in penalties three times the amount of the restitution awarded to the State.

The statute amends the Medicaid False Claims Act to provide whistleblowers with legal protection, as well as a financial incentive to those willing to bring a civil suit against, and assist in, the investigation and prosecution of a violator of the Medicaid False Claims Act. For instance, the person who brought the case shall receive 15-25 percent of the proceeds of the action or settlement of the claim plus reasonable attorney fees. Any person with knowledge of a violation of the Medicaid False Claims Act may bring a civil action in the name of the State of Michigan, and must provide a copy of the complaint and written disclosure of substantially all material evidence to the Attorney General.

In addition, the Attorney General may elect to intervene and proceed with the action within 90 days. If the Attorney General does intervene, then the Attorney General has primary responsibility for prosecuting the case.

Any employee who is discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against in the terms and conditions of employment by his or her employer because of their participation in this action, will be entitled relief, which includes reinstatement with the same seniority status, 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.

The Attorney General's Health Care Fraud Division is one of 49 federally certified Medicaid Fraud Control Units. Medicaid fraud investigations and prosecutions include false billings, unlawful delivery of controlled substances, practicing medicine without a license, kickbacks, and bribery schemes. Abuse and neglect investigations and prosecutions include physical assault, criminal sexual conduct, identity theft, theft of residents' property and funds, and harmful neglect in Michigan residential care facilities. The division also initiates civil actions, including asset forfeiture and claims for Medicaid overpayments.

To report Medicaid provider fraud or identity theft/patient abuse in a resident care facility, call the Attorney General's 24-hour Hotline at 800-24-ABUSE (800-242-2873); e-mail hcf@michigan.gov; or visit the Attorney General's Web site at http://www.michigan.gov/ag.

Source: prnewswire

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