Michigan Medicaid False Claims Act

By Joy Clairmont

The Michigan Medicaid False Claims Act encourages individuals with information related to Medicaid fraud being perpetrated against the State of Michigan to file a lawsuit on behalf of the State and share in any recovery.

Michigan Medicaid False Claims Act Liability

As the name implies, the Michigan Medicaid False Claims Act (“Michigan Medicaid FCA”) specifically applies to fraud involving State Medicaid funds. The law prohibits making false statements or claims to obtain Medicaid funds, and also forbids paying kickbacks and making false statements to obtain certification or recertification of certain facilities. Specifically, the Michigan Medicaid FCA states that any person or entity can be liable for:

  • Knowingly making or causing to be made a false claim to the State.
  • Knowingly making or causing to be made a false record or statement to conceal, avoid or decrease an obligation to pay money to the State.
  • Knowingly making or causing to be made a claim that falsely represents that the goods or services for which the claim is made were medically necessary.
  • Knowingly making a false statement or false representation as to the conditions or operations of a facility (e.g., hospital, skilled nursing facility, intermediate care facility or home health agency) so that the facility may qualify for certification or recertification.
  • Offering or receiving a kickback or bribe in connection with the furnishing of goods or services paid for by Medicaid.

Michigan Medicaid False Claims Act Damages

If an individual or company is found to have violated the Michigan Medicaid FCA, they are liable for a civil penalty of at least $5,000 and no more than $10,000, plus three times the amount of damages which the State sustained. A person or entity is also liable to the State for all costs that the State incurred in the litigation and recovery, including the cost of investigation and attorneys’ fees.

The Michigan Medicaid FCA also includes very stiff criminal penalties for felony violations of the law, including imprisonment of four to ten years depending on the particular violation, as well as payment of a fine from $30,000-$50,000.

Michigan Medicaid False Claims Act Relator’s/Whistleblower’s Award

Once a relator/whistleblower files an action on behalf of Michigan, the State will conduct an investigation into the allegations and then make a decision as to whether to “intervene” and take on the action as their own, or decline to intervene.

If the State proceeds with the action and obtains a recovery, the whistleblower will receive 15-25% of the proceeds of the action or settlement of the claim, depending on the amount of effort involved. If the State declines to proceed with the action, the whistleblower shall receive 25-30% of the action or settlement’s proceeds.

Contact Us to Learn More

Do you need a Whistleblower Lawyer or want to know more information about Qui Tam Law and your rights under the False Claims Act?

There are three easy ways to contact our firm for a free, confidential evaluation with one of our whistleblower attorneys:

  1. Fill out the contact form on this page.
  2. Email quitam@bm.net
  3. Call (800) 424-6690

Your submission will be reviewed by a Berger Montague qui tam attorney and remain confidential.

if you believe an individual or company is defrauding Michigan’s Medicaid program, click here to speak with a berger montague whistleblower attorney. your information will remain confidential.
By | 2018-08-01T10:37:13+00:00 July 31st, 2018|False Claims Act Information|