Washington Medicaid Fraud False Claims Act

The Washington state legislature recently passed a bill which would bring Washington within the majority of states with a state False Claims Act modeled after the whistleblower and fraud provisions of the federal False Claims Act.  Under the Washington Medicaid Fraud False Claims Act, whistleblowers with knowledge of fraud on Washington medical assistance funds may bring suit on the state’s behalf and share in the recovery.

Violation of the Washington Medicaid Fraud False Claims Act exposes an individual for civil penalties up to three times the total damages to the state.  Further, the Act imposes civil penalties ranging between $5,500 – $11,000 for each individual false claim in violation of the Act.

A private individual with direct knowledge of a Washington Medicaid Fraud False Claims Act violation is authorized to file a suit under the Act’s qui tam provisions.  The qui tam relator, often referred to as a “whistleblower,” may proceed with the action regardless of whether the government chooses to intervene.

Whistleblowers involved in successful judgments or settlements may receive up to 25 percent of the civil penalties recovered by the state government.  If the state government has chosen not to intervene, the whistleblower may receive up to 30 percent of the available recovery. Further, the Act provides the whistleblower with protection against employer retaliation, offering reinstatement, double back pay with interest, and compensation for any special damages including attorneys’ fees if the employee lawfully acted in furtherance of an action under the Washington Medicaid Fraud False Claims Act.

Persons with information about fraud on the state of Washington are urged to preserve their rights by consulting an attorney and filing a case as soon as possible.  A disclosure to the Washington state government may preserve a person’s rights as an original source of the information about fraud.

The bill was signed into law on March 30. Washington spent approximately $8.5 billion on its Medicaid program last year, but only recovered $20 million in fraud prosecutions.  In addition to Washington, other states without an existing state False Claims Act are considering passage of a law to recover fraud on state Medicaid funds and participate in multi-state False Claims Act recoveries.