North Carolina Enacts Qui Tam Remedies Against Medicaid Fraud
Thursday, September 10th, 2009
North Carolina has a new False Claims Act (“State FCA”) effective January 1, 2010, permitting private citizens to file civil qui tam (whistleblower) actions in the State’s name to recover treble damages, plus civil penalties, costs, and attorneys’ fees against any Medicaid provider who knowingly submits or causes to be submitted to the State a false or fraudulent claim for payment or approval. The new act (House Bill 1135), codified under Chapter 1, Article 52 (N.C.G.S §§1-605 through 617), applies to all claims submitted to the state (education, transportation, education, for example), not just claims for Medicaid reimbursement. It applies not only to claims made by Medicaid providers and other contractors but also to the retention of overpayments by providing remedies and penalties against anyone who “knowingly makes, uses, or causes to be made or used a false record or statement material to an obligation to pay or transmit money or property to the State or knowingly conceals or …. avoids or decreases an obligation to pay or transmit money or property to the State.”