Tennessee Medicaid False Claims Act: Violations and Whistleblower Award

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The Tennessee Medicaid False Claims Act came into existence in 1993. With the state legislature endorsing the legislation to split the Tennessee False Claims Act, a new law was enacted with exclusive focus on recovering embezzlement of healthcare funds. The older act with amendments continues to prevent fraudulent appropriation of state funds and punish perpetrators. In the recent years, the state has been able to recover millions of dollars defrauded through up-coding and false billing by many health service providers with more than a third of the recovered amount awarded to whistleblowers.

Tennessee Medicaid False Claims Act: The Coverage and Violations

Any fake claim made with an intention to get Medicaid reimbursements higher than the actual cost incurred is subject to recovery under Tennessee Medicaid False Claims Act. The provisions of the act cover TennCare funds and any other alternative Medicaid program succeeding the existing one.

Tennessee Medicaid False Claims Act considers the following types of actions as a violation of its provisions.

• Presenting false claims for payment from Medicaid funds
• Falsifying a record to seek a false Medicaid payment claim
• Involvement in conspiracy to defraud Medicaid money
• Avoiding or intentionally reducing obligation to pay any Medicaid-related amount to the state
• Acting in an ignorant manner despite being aware of false payments
• Disregard or deliberate ignorance of the false payment

Civil Action and Award to Whistleblowers

• The Tennessee Medicaid False Claims Act details the procedure for a civil action to be brought by a whistleblower or a quit tam plaintiff. A whistleblower should be an insider while any one can turn to be a quit tam relator seeking to recover state funds misappropriated. Your TN false claim lawyer should file a complaint under the act in camera and submit material evidence within 60 days. The defendant is notified of the false claim lawsuit only after the expiry of 60-day period.
• The state is free to join or reject a call to participate in any TN Medicaid false claim lawsuit and settle it with the concurrence of the court. The plaintiff can proceed alone and represented by his TN false claim lawyer when the state withdraws from the litigation.
• Compensation ranging from 15 to 25 percent of the recovered amount is granted to the whistleblower when state joins the prosecution. The compensation amount is enhanced between 25 and 30 percent of total settlements when the quit tam plaintiff proceeds with his own TN false claim lawyer and state does not participate in the process. The court can also ask the defendant to pay to the plaintiff any sum it thinks reasonable for the plaintiff to cover expenses incurred, legal costs, and attorney fees.

Tennessee Medicaid False Claims Act: Punishment and Recovery

A large number of Tennessee Medicaid false claim lawsuits have been filed in the last two decades citing embezzlement of state funds through upcoding, double billing, misleading medical procedures, fabricated medical test reports, phantom billing, submission of false claims, and such other practices. The Tennessee Medicaid False Claims Act provides for tough penalty and imposes economic damages to punish those involved in such practices.

The act seeks to recover thrice the damages to the state exchequer from the individual found guilty of making misleading Medicaid claims. An additional civil penalty ranging from $5,000 to $25,000 is also imposed on the defendant.

As a goodwill gesture, the Tennessee Medicaid False Claims Act empowers the court to reduce the recovery to twice the money defrauded, if the defendant fully cooperates with the investigation and furnishes the full details of false claim payments within 30 days.

FOR FALSE CLAIMS ACT HELP, PLEASE CONTACT US.

We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today, or visit our False Claims Act Litigation Source.

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Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.