Michigan Votes Forum

Introduced in the House on February 19, 2008, to add a civil fine of at least $5,000 and up to $10,000 to the existing penalty for making a false Medicaid claim, which is triple the damages suffered by the state for the false claim. The bill would also prohibit using a false record or statement to conceal, avoid, or decrease an obligation to make a payment to the state related to a Medicaid claim

The vote was 105 in favor, 0 opposed and 5 not voting

(House Roll Call 175 at House Journal 26)

Click here to view bill details.

Fraud has raised its ugly head as the financial culprit in this global economic crisis, yet fraud is still allowed to lurk behind obfuscatory law and policies in Michigan, particularly in the Medicaid False Claims Act. Medicaid fraud is not just a pattern of waste and abuse, it is the financial terrorist that jeopardizes our Social Security and our children's Social Security. On July 24, 2008 the U.S. Department of Health and Human Services Director Inspector General Daniel R. Levinson sent a supplemental review of Michigan's Medicaid False Claims Act to William T. Hart, Director of Michigan Medicaid Fraud Control Unit, Office of Attorney General, itemizing the deficiencies of the statute. The importance of correcting the flaws of MCL 400.601 through 400.613 is to not just be in federal compliance of the Deficit Reduction Act, but to become eligible for the financial incentives offered to the state. The U.S. DHHS has laid the sword of incentives to slay the monster, fraud, at the foot of the state, but in order for the state to retrieve its weaponry, it must join in the oath with the rest of the states that it will and shall battle fraud to its end. Bringing the Medicaid False Claims Act into federal compliance is the first step of fiscal accountability. Ending the gorge of fraud upon the state budget protects taxpayer dollars and the future of our children. I pray this bill to be put on the fast track to the Governor's desk. There are no more excuses. Beverly Tran

Michigan is the last state in this nation to produce an effective tool against Medicaid fraud. Every year Michigan taxpayers are defrauded out of tens of millions of dollars, only to have more money sunk into unregulated programs and services of the state budget, further increasing the national deficit. This Legislature continues to statutorily constrain Attorney General in fighting fraud and garnering a state bounty of %10 of the federal share of recouped funds. Michigan has one of the most powerful Attorney Generals in the nation, yet, the Senate refuses to unleash our state's mighty force to protect the general welfare of its citizens. The following is the supplemental review of Michigan's Medicaid False Claims Act: United States Department of Health and Human Services, Office of the Inspector General July 24, 2008 Wallace T. Hart, Director Michigan Medicaid Fraud Control Unit Department of Attorney General P.O. Box 30218 Lansing, Michigan 48909 Dear Mr. Hart: This letter supplements the December 21, 2006 letter from the Offce of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) regarding OIG's review of the Michigan Medicaid False Claim Act, Mich. Comp. Laws §§ 400.601 through 400.613, under the requirements of section 6031(b) of the Deficit Reduction Act (DRA). Section 6031 of the DRA provides a financial incentive for states to enact laws that establish liability to the state for individuals and entities that submit false or fraudulent claims to the state Medicaid program. For a state to qualify for this incentive, the state law must meet certain requirements enumerated under section 6031 (b) of the DRA, as determined by the Inspector General of HHS in consultation with the Department of Justice (DOJ). Based on our review of the law and consultation with 001, we have determined that the Michigan Medicaid False Claim Act does not meet the requirements of section 6031(b) of the DRA. Section 6031 (b)(1) of the DRA requires the state law to establish liability to the state for false or fraudulent claims described in section 3729 of the Federal False Claims Act. The Federal False Claims Act defines "knowing" and knowingly" to mean that a person has actual knowledge of the information; acts in deliberate ignorance of the truth or falsity of the information; or acts in reckless disregard of the truth or falsity of the information. See 31 U.S.c. § 3730(d)(3). In contrast, the Michigan Medicaid False Claim Act defines "knowing" and "knowingly" to mean that "a person is in possession of facts under which he or she is aware or should be aware of the nature of his or her conduct and that his or her conduct is substantially certain to cause the payment of a medicaid benefit" and provides that "(k)nowing or knowingly does not include conduct which is an error or mistake unless the person's course of conduct indicates a systematic or persistent tendency to cause inaccuracies to be present." Mich. Camp. Laws § 400.602(f). Because the Michigan Medicaid False Claim Act does not define knowing or knowingly to include deliberate ignorance or reckless disregard, it does not establish liability for false or fraudulent claims as described in section 3729 of the Federal False Claims Act. Section 603 i (b)(2) of the DRA requires the state law to contain provisions that are at least as effective in rewarding and facilitating qui tam actions for false and fraudulent claims as those described in sections 3730 through 3732 of the Federal False Claims Act. The Federal False Claims Act provides that the court may reduce the share awarded to the relator if the coui1 finds that the relator planned and initiated the violation upon which the action was brought. See 31 US.C. § 3730(d)(3). In contrast, the Michigan Medicaid False Claim Act provides that the court may reduce or eliminate the share awarded to the relator if the court finds that the relator "planned, initiated, or participated in" the conduct upon which the action is brought. See Mich. Compo Laws § 400.610a(11). Based on this provision, the Michigan Medicaid False Claim Act is not at least as effective in rewarding or facilitating qui tam actions as the Federal False Claims Act. In addition, the Federal False Claims Act provides that a relator may not bring a qui tam action that is based upon allegations or transactions that are the subject of a civil suit or an administrative civil money penalty proceeding in which the government is already a party. See 31 U.S.C. § 3730(e)(3). In contrast, the Michigan Medicaid False Claim Act provides that "(a) person other than the attorney general shall not bring an action under this section that is based on allegations or transactions that are already the subject of a civil suit, a criminal investigation or prosecution, or an administrative investigation or proceeding to which this state or the federal government is already a party" and that "(t)he court shall dismiss an action brought in violation of this section." See Mich. Comp. Laws § 400.610a(12). Because this provision prohibits qui tam actions when there is already a criminal or administrative investigation, it is not at least as effective in rewarding and facilitating qui tam actions as the Federal False Claims Act. In addition, the Federal False Claims Act provides that an action may not be brought after the later of: (1) six years after the date on which the violation is committed; or (2) three years after the date when the facts material to the right of action are known or reasonably should have been known by the official of the United States charged with responsibility to act in the circumstances, but in no event more than ten years after the date on which the violation is committed. See 31 U.S.C. § 3731(b). In contrast, the Michigan Medicaid False Claim Act does not include a statute of limitations. The Michigan statute that governs statutes of limitations in civil cases generally provides for a six-year statute of limitations. See Mich. Comp. Laws § 600.5813. Because a shorter statute of limitations applies to actions brought under the Michigan Medicaid False Claim Act, it is not at least as effective in rewarding and facilitating qui tam actions as the Federal False Claims Act. In addition, the Federal False Claims Act provides that the government is required to prove all essential elements, including damages, by a preponderance of the evidence. See 31 U.S.c. § 3732(c). The Michigan Medicaid False Claim Act does not include a burden of proof. However, Michigan Model Civil lury Instruction 8.0 i states that the burden of proof in civil cases is clear and convincing evidence. Because the Michigan Medicaid False Claim Act doesn't include a burden of proof and a more stringent standard of proof applies to actions brought under the Michigan Medicaid False Claim Act, it is not at least as effective in rewarding and facilitating qui tam actions as the Federal False Claims Act. Lastly, the Federal False Claims Act provides relief to employees who are discharged, demoted, suspended, threatened, harassed, or in any manner discriminated against in the terms or conditions of employment by his or her employer because of lawful acts done in furtherance of an action under the Federal False Claims Act. See 31 U.S.C. § 3730(h). The Michigan Medicaid False Claim Act includes similar relief to employees, but exempts from protection employees who merely participated in the conduct upon which the action was brought. See Mich. Comp. Laws § 400.610c. Based on this provision, the Michigan Medicaid False Claim Act is not at least as effective in rewarding and facilitating qui tam actions as the Federal False Claims Act. If the Michigan Medicaid False Claim Act is amended to address the issues noted above, please notify OIG for further consideration of the Michigan Medicaid False Claim Act. If you have any questions regarding this review, please contact me, or your staff may contact Susan Elter Gilln at 202-205-9426 or susan.gillin@oig.hhs.gov or Katie Arnolt at (202) 205-3203 or katie.arnholt@oig.hhs. gov. Sincerely, Daniel R. Levinson Inspector General cc: Aaron If you still need further assistance to adopt an effective Medicaid False Claims Act, you may contact me. Beverly Tran

For many years the Congress of the United States has worked diligently to protect the health and welfare of the nation's elderly and poor by implementing legislation to prevent certain individuals and businesses from participating in Federally-funded health care programs. Legally Kidnapped has mandated that the health and welfare of the nation's children and families must be protected by including Child Welfare Agencies in this exclusion database. Foster Care and Adoption Agencies should be banned from entering contracts using federal funds if the bases for exclusion have been met. Bases for exclusion include for child welfare program-related fraud, child abuse, child deaths, licensing board actions, improper and questionable claims, false reports. The effect of not being able to participate in federally funded contracts is: * No payment will be made by any Federal child welfare program for any items or services furnished, ordered, or prescribed by an excluded individual or entity. Federal foster care and adoption programs include Medicaid Targeted Case Management, and Social Security Title IV A, B, D, and E, Maternal and Child Health Services Block Grant (Title V), Block Grants to States for Social Services (Title XX), State Children's Health Insurance (Title XXI) and all other plans and programs that provide health benefits for foster care and adoption funded directly or indirectly by the United States. The reason for this database is because on April 18, 2008 the U.S. finally signed the U.N. Hague Convention InterCountry Adoption Treaty. Contained within this treaty is where the mandate for databases of complaints is found. This not only meets the international requirements of the treaty, it will make DOJ and DHHS OIG job alot easier when they start the audits next spring. Michigan needs an exclusionary database. Stop doing business with those who commit fraud. Feel free to visit the Central Registry of Child Welfare Fraud! Beverly Tran