In 1995, the State of Texas passed its own version of the
federal False Claims Act ("FCA"), the Texas Medicaid Fraud
Prevention Act ("TMFPA"). The TMFPA is specifically geared toward
combatting fraud against the Texas Medicaid Program. The Texas
Medicaid Program provides health care and prescription drug
coverage to low-income individuals. It also contains "qui tam"
provisions, allowing private individuals who have knowledge as to
fraud against the Texas Medicaid Program to bring an action on
behalf of the State of Texas for violations of the TMFPA. If the
Attorney General declines to take over the action, the private
person may prosecute the case under the TMFPA in the name of the
State of Texas.
Texas Medicaid Fraud Prevention Act and the Federal False Claims
Although the federal FCA and the TMFPA contain many similar
fraud-fighting provisions, the TMFPA includes some unique
Texas Medicaid Fraud Prevention Act in Action
The Texas Attorney General's Office has been at the forefront of
prosecuting qui tam cases. In particular, the State of Texas has
aggressively and vigorously pursued actions against pharmaceutical
companies for fraudulent drug pricing. Some of the State's more
recent victories, returning tens of millions of dollars to the
State's general revenue fund, include the following:
In total, as of April 2015, the Texas Attorney General Office's
Civil Medicaid Fraud Division has successfully recovered over $600
million from defendants who have defrauded the State Medicaid
Program in violation of the TMFPA. This incredible record of qui
tam recoveries demonstrates the fraud-fighting power of aggressive
State prosecutors working with the assistance of private individual
For more information on the Texas Medicaid Fraud Prevention Act
or to speak with an attorney, please contact Joy Clairmont at firstname.lastname@example.org or
215-875-5803. To read more about what whistleblower clients can
expect from our lawyers,
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What is Qui Tam