§1396h State False Claims Act Requirements for Increased State Share of Recoveries

Summary

If a State has a law against false or fraudulent claims that meets certain rules, the federal share of Medicaid money linked to any amounts the State recovers under that law will be lowered by 10 percentage points. The HHS Inspector General, with the U.S. Attorney General, must say the State law does four things: lets the State sue for false claims tied to Medicaid spending; gives private whistleblowers the right to bring suits and share in recoveries at least as well as the federal rules; requires new suits to be filed under seal for 60 days so the State Attorney General can review them; and sets civil penalties at least as large as the federal penalty. A State that had such a law on January 1, 2007 is treated as meeting these rules as long as the law keeps meeting them. If the law also covers other programs or spending, it still counts if it meets the same requirements.