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Friday, March 15, 2013

OIG Updates Guidance for State False Claims Act Laws

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For the first time ever, OIG has updated the guidelines for evaluating state false claims act laws, taking into account amendments made to the federal false claims act in 2009 and 2010. Under the guidelines, which were originally released in 2006, OIG uses four crtieria to determine whether a state has a qualifying FCA law; if so, the state's share of any Medicaid recoveries made under their FCA will be increased by 10 percentage points. OIG must determine whether a state's FCA law:

  • establishes liability for false or fraudulent claims;
  • contains provisions that are at least as effective in rewarding qui tam actions as those in the federal FCA;
  • contains a requirement for filing an action under seal for 60 days with review by the state attorney general; and
  • contains a civil monetary penalty that is not smaller than the CMP authorized by the federal FCA

The updated guidelines incorporate amendments to the federal FCA made by the Fraud Enforcement and Recovery Act, the Affordable Care Act, and the Dodd-Frank Wall Street Reform and Consumer Protection Act into OIG's evaluation of state FCA laws. Changes include an increase in the amount of the CMP authorized by the federal FCA.

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