Qui Tam

Missouri's Medicaid Fraud Control Unit Ranked Number One in FY 2008, Despite Not Having a State False Claims Act

By Zachary A. Kitts

Missouri Attorney General Chris Koster said today that Missouri has earned the distinction of returning more money to the public fisc through Medicaid fraud prosecutions than any other state in the nation.  This is, however, only when the federal Medicaid grant to Missouri is considered:  according to national data from the federal Department of Health and Human Services (HHS), the Attorney General's Medicaid Fraud Control Unit obtained $18.81 for every federal dollar received in federal fiscal year 2008.

The Missouri Attorney General's Medicaid Fraud Control Unit received a grant of $1,582,000 from HHS in federal fiscal year 2008, and used that funding to recover $29,753,505, for the return rate of $18.81 per grant dollar and the number one ranking nationally.

As a lawyer practicing in the area of qui tam litigation under the federal False Claims Act and the various state false claims acts, I would not be doing my duty if I didn't point out some of the puffery in General Koster's statement. 

First, although Missouri does not have a state false claims act, it still benefits from the national cases filed by qui tam whistleblowers.  Missouri particularly benefited from the national drug settlements in 2008, several of which were in the billions of dollars, and all of which were initiated by qui tam whistleblowers with personal, first-hand knowledge of the fraud. 

Second, Missouri's achievement must be put in perspective.  The total amount recovered by Missouri in 2008 was $29.7 million--when compared to Virginia's $650 million in 2007 using the Virginia Fraud Against Taxpayers Act, we see that Missouri's achievements become a little more humble. 

General Koster said:  "Efficiency of government is critical, particularly during these challenging economic times," Koster said. "Missouri's Medicaid Fraud Unit has used all tools available to aggressively investigate and prosecute Medicaid fraud, and return those stolen health care dollars to Missouri."

They may well have used all of the tools available to them, but they did not push for the most important weapon--a state false claims act with qui tam whistleblower provisions.

I must say that I find it strange that Koster did not mention qui tam whistleblowers as part of his equation--and he also didn't use this press opportunity to push for passage of a state false claims act. 

General Koster is no doubt a very capable AG, and he no doubt has a very fine staff, but they need the proper tools to really be able to make a difference.

Below is the ranking of recovery rates per federal grant dollar spent:

RANK, STATE, PER GRANT DOLLAR 

1.        Missouri $18.81
2.        North Carolina $18.38
3.        Tennessee $17.13
4.        West Virginia $15.69
5.        Ohio $15.38
6.        Maine $14.73
7.        South Carolina $14.25
8.        Minnesota $13.67
9.        Nebraska $11.36
10.       Georgia $10.79
11.       Texas $10.77
12.       Kentucky $10.13
13.       Kansas $ 9.21
14.       Massachusetts $ 9.18
15.       Indiana $ 8.92
16.       Oklahoma $ 8.83
17.       Washington $ 8.61
18.       New Jersey $ 8.07
19.       Vermont $ 8.02
20.       New Hampshire $ 7.52
21.       Oregon $ 7.34
22.       Maryland $ 7.27
23.       Pennsylvania $ 7.12
24.       Louisiana $ 6.83
25.       Florida $ 6.76
26.       New York $ 6.65
27.       Alabama $ 6.54
28.       Virginia $ 6.04
29.       Michigan $ 5.75
30.       California $ 5.70
31.       Illinois $ 5.55
32.       South Dakota $ 5.51
33.       Mississippi $ 5.17
34.       Connecticut $ 4.80
35.       Utah $ 4.56
36.       Iowa $ 3.99
37.       Wisconsin $ 3.91
38.       District of Columbia $ 3.69
39.       Colorado $ 3.66
40.       Rhode Island $ 3.40
41.       Arkansas $ 2.65
42.       Nevada $ 2.15
43.       Arizona $ 2.07
44.       Wyoming $ 1.96
45.       Hawaii $ 1.15
46.       Alaska $ 1.02
47.       New Mexico $ 1.00
48.       Montana $ .92
49.       Delaware $ .78
50.       Idaho $ .06

Full post as published by Virginia Qui Tam Law on January 27, 2010 (boomark / email).