Recovery provision for whistleblowers provides new tool in fight against Medicaid fraud

Jefferson City, Mo. — Missourians who blow the whistle on Medicaid fraud by healthcare providers soon may be eligible for a portion of any money recovered by the state, Attorney General Jay Nixon said. Under a new law that takes effect Aug. 28, any person who is the original source of information used by the Attorney General to recover money for the state may receive 10 percent of the state's recovery. "Some of our biggest successes in fighting fraud have come with the assistance of Missourians who see something that doesn't look right and then contact my office," Nixon said. "This tool will further encourage citizens to be on the lookout for those who defraud the Medicaid program through false billing." Nixon's office will begin receiving complaints under the whistleblower provision on Aug. 28. To qualify, the individual who makes the complaint must be the original source of the information, and the information must not already be known by the government or the public. The individual also must not have planned, initiated or participated in the fraud being reported. Nixon encourages anyone with information about Medicaid fraud by healthcare providers to contact his Medicaid fraud hotline at 1-800-286-3932 or to e-mail those complaints to ag@ago.mo.gov. The Attorney General's Web site, ago.mo.gov, also contains answers to frequently asked questions about Medicaid fraud. The Medicaid Fraud Control Unit of the Attorney General's Office, established by Nixon in 1994, has authority under state law to investigate and prosecute allegations of Medicaid provider fraud, both civilly and criminally. In the past eight years, the unit has recovered more than $84 million for Missouri's Medicaid program. Last year, the unit ranked 2nd in the nation in recovery rate. The unit recently obtained a settlement of more than $5.8 million with Purdue Pharma , the makers of the pain medication Oxycontin, over allegations that company representatives improperly promoted the drug to healthcare providers.