The federal False Claims Act (FCA) only applies to fraud against the federal government, not the states, and therefore does not cover the states’ share of Medicaid spending. Passage of state FCAs will plug this loophole.

Some states have enacted their own false claims act with qui tam provisions that reward whistleblowers with a share of the state portion of recoveries in cases of Medicaid fraud. Currently, thirteen states and the District of Columbia have enacted such laws: California, Delaware, Florida, Hawaii, Illinois, Louisiana, Massachusetts, Nevada, New Hampshire, New Mexico, Tennessee, Texas, and Virginia. These states account for about 35 percent of all federal Medicaid spending.

Memo and Text of model bill (77 KB MSWORD)