(Tenn. Code Ann. §§ 71-5-181 to 185)
By Russell Paul
The Tennessee Medicaid False Claims Act (“Tennessee Medicaid FCA”) allows whistleblowers to sue in the name of the State of Tennessee where a wrongdoer engages in conduct that defrauds the state or local government of its healthcare dollars. This statute is designed to address Medicaid fraud. The Tennessee Medicaid FCA imposes liability on people and corporations who knowingly submit false claims to TennCare, Tennessee’s Medicaid program.
A Tennessee Medicaid FCA defendant may be liable for up to three times the actual harm to the state, as well as a penalty of between $5,000 and $25,000 for each violation.
A whistleblower who files a successful qui tam claim under the Tennessee Medicaid FCA may receive between 15 and 25 percent of any recovery to the state if the attorney general intervenes in the matter. If the whistleblower proceeds with the case on her own, she may receive between 25 and 30 percent of the award. The court may reduce the value of the award if the whistleblower planned and initiated the fraud, or if the action is largely based on disclosures in the media or public hearings.
Plaintiffs must file their complaint within ten years of the date on which the violation occurred.
The Tennessee Medicaid FCA protects whistleblower employees from retaliation by their employers for filing a claim or assisting the state with its own claim.
Note that Tennessee also has a separate False Claims Act. It imposes liability on persons who knowingly present false or fraudulent claims for payment to the state outside of the Medicaid program, misappropriate state property, or deceptively avoid binding obligations to pay the state, among other violations.
Previous Tennessee Medicaid False Claims Act Settlements
Numerous qui tam cases have been prosecuted under the Tennessee Medicaid FCA, recovering funds for both the state government and Tennessee taxpayers:
- Matthew Anderson: In January 2018, a Tennessee chiropractor named Matthew Anderson paid $1.45 million to resolve allegations that he improperly billed Medicare and TennCare for painkillers that had no legitimate medial purpose.
- Anindya Sen and Patricia Posey Sen: In June 2017, Dr. Anindya Sen and Patricia Posey Sen agreed to pay $1.2 million to resolve allegations that their medical practice billed Medicare and TennCare for anticancer and infusion drugs that were produced for sale in foreign countries and not approved by the FDA for marketing in the United States.
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:
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