Virginia Healthcare Fraud/Medicare Fraud Enforcement

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In Virginia, major healthcare fraud is civilly and criminally prosecuted by the Western and Eastern District United States Attorney’s Offices and the State’s own Medicaid Fraud Control Unit.

The federal government often accomplishes this task with the assistance of the VirginiaMedicaid Fraud Control Unit (MFCU). The MFCU takes the responsibility of stopping fraud very seriously and is often assisted in its efforts by the bravery and actions of whistleblowers.

Modeled after the federal False Claims Act, the Virginia Fraud Against Taxpayers Act permits private citizens to bring qui tam actions on behalf of the State of Virginia to recover treble damages and civil penalties. Va. Code Ann. §§ 01-216.1 et seq.

Nolan Auerbach & White represents whistleblowers in federal court only. We will bring cases on behalf of whistleblowers under the Virginia qui tam statute as part of an action under the federal False Claims Act. We do so under the Court’s pendent jurisdiction.

The liability provisions of the Virginia Fraud Against Taxpayers Act, Va. Code Ann. § 8.01-216.3A, provide liability for any person who:

1. Knowingly presents, or causes to be presented, to an officer or employee of the Commonwealth a false or fraudulent claim for payment or approval;

2. Knowingly makes, uses, or causes to be made or used, a false record or statement to get a false or fraudulent claim paid or approved by the Commonwealth;

3. Conspires to defraud the Commonwealth by getting a false or fraudulent claim allowed or paid;

 

Cases completed in Virginia that were originally brought in Virginia in a Virginia federal court include:

 

FOBRA Holdings LLC, a dental management company that provides business management and administrative services to 69 clinics nationwide known as “Small Smiles Centers,” agreed to pay the United States $24 million plus interest, to settle allegations that it caused bills to be submitted to state Medicaid programs for medically unnecessary dental services performed on children insured by Medicaid—a program that is funded jointly by the federal and state governments.