OLYMPIA — A new joint legislative audit report encourages the Legislature to renew its Medicaid False Claims Act (FCA), noting its highly effective use by the Attorney General’s Office (AGO) in the three years since its original passage. The preliminary report will be the subject of a legislative hearing tomorrow.
Medicaid fraud diverts taxpayer funds meant for legitimate health care needs. The new report, issued by the bipartisan Joint Legislative Audit and Review Committee (JLARC), found several key impacts, including a conclusion that recoveries have increased because of the FCA — a 28 percent increase in civil fraud recoveries since passage and a recovery of $3 for every $1 invested in enforcement under the act.
Since 2012, the Attorney General’s Office has recovered $6.1 million that it otherwise would not have been able to without its authority under the FCA.
The report highlights that the FCA allows the state to pursue additional fraud cases through civil actions. Without it, the AGO’s primary tool to fight Medicaid fraud would be criminal prosecutions, which require a higher burden of proof and do not afford the extraordinary damage and penalty provisions of the FCA.
Fraud referrals obtained through inside whistleblowers under the FCA are relied upon by the AGO to detect and deter complex medical fraud schemes. The report found no evidence of abuse of the act’s whistleblower, or qui tam, provision, a potential concern raised by some detractors when the law was originally before the Legislature.
If the FCA is not renewed, Washington could lose significant federal dollars. The federal government provides a $3-to-$1 match for all state moneys provided to the AGO to enforce the False Claims Act.
The state would also lose its full partnership with the National Medicaid Fraud Control Unit, reducing its ability to be fully represented in large, national Medicaid fraud cases. Whistleblower protections provided by the FCA would also disappear.
Following Wednesday’s JLARC hearing, a final report will be released to the public in early December and presented to the full JLARC Committee in Olympia on Dec. 9, 2015. Unless the Legislature takes action, the current act will expire June 30, 2016.
The Office of the Attorney General is the chief legal office for the state of Washington with attorneys and staff in 27 divisions across the state providing legal services to roughly 200 state agencies, boards and commissions. Attorney General Bob Ferguson is working hard to protect consumers and seniors against fraud, keep our communities safe, protect our environment and stand up for our veterans. Visit www.atg.wa.gov to learn more.
Peter Lavallee, Communications Director, (360) 586-0725; PeterL@atg.wa.gov