OLYMPIA—Governor Jay Inslee today signed Attorney General Bob Ferguson’s agency-request bill to combat Medicaid provider fraud by reauthorizing the state’s highly effective Medicaid Fraud False Claims Act.
Unscrupulous medical providers seek to profit from the state’s Medicaid program — knowingly performing unneeded tests, knowingly charging for services not provided, and otherwise defrauding and abusing the Medicaid system.
One of the state’s most effective tools to combat Medicaid fraud is the Medicaid Fraud False Claims Act (FCA), which authorizes the Attorney General to bring civil cases against fraudulent providers to recover Medicaid funds. The Act enables the Attorney General to return millions of dollars in stolen Medicaid dollars back to the state.
The law originally included an expiration, or “sunset,” provision. Senate Bill 6156 removes the sunset for the bulk of the FCA and extends the sunset on the qui tam, or “whistleblower,” provisions of the Act until 2023. Without action from the Legislature, the FCA would have expired June 30, 2016.
“I am committed to protecting taxpayers from fraud and abuse,” Ferguson said. “Thanks to action by the Governor and the Legislature, my Medicaid Fraud Control Unit can continue recovering stolen dollars lost to fraud, deterring misuse of government funds, and holding fraudsters accountable.”
Sen. Ann Rivers, R—La Center, sponsored the bill signed into law today.
“This legislation represents the kind of common-sense measures that taxpayers wish lawmakers would champion more often,” said Rivers. “I am honored to be part of ensuring that this cost-savings and consumer-protection act remains strong.”
Rep. Laurie Jinkins, D—Tacoma, sponsored the companion bill in the House.
“There's been a lot of talk about accountability this session,” Jinkins said. “This bill will ensure that patients are getting the care they need and that the government investments in patient care are being used effectively and efficiently. Since we first enacted this, we've had a 3–1 return on investment. That's what accountability looks like.”
The False Claims Act was controversial when it was passed by the Legislature in 2012, passing the House by a mostly party-line vote of 56-42. Concerns were expressed that the law’s “qui tam” provision, allowing whistleblowers to bring evidence of fraud to the Attorney General in return for a share of the recovery, would lead to widespread frivolous claims.
Those concerns never materialized.
The bill signed into law today was supported by the Liability Reform Coalition, which opposed the Act when it was passed in 2012.
In Dec. 2015 the Joint Legislative Audit & Review Committee (JLARC) unanimously approved an independent audit report encouraging the Legislature to renew the FCA. The JLARC Report found no evidence of frivolous claims arising from the Act.
JLARC’s Medicaid Fraud False Claims Act Sunset Review notes that the Attorney General’s use of the FCA has been highly effective in the three years since its original passage. Since the act’s passage, civil fraud recoveries have increased 28 percent, and the state has recovered $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.
If the FCA had not been renewed, Washington could have lost 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 have also lost its full partnership with the National Medicaid Fraud Control Units, reducing its ability to be fully represented in large, national Medicaid fraud cases. Whistleblower protections provided by the FCA would have also disappeared.
Ferguson thanked all the bill cosponsors in the Senate and House whose work made today’s legislation possible.
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, PeterL@ATG.WA.GOV