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CCH False Claims Policy

In the United States, under the False Claims Act, a private individual, or “whistleblower,” with knowledge of past or present fraud committed against the federal government to bring suit on its behalf.

Federal Deficit Reduction Act of 2005, Section 6032
Overview of Section 6032 of the DRA
Section 6032 of the DRA requires state Medicaid plans to provide that any entity that receives or makes annual payments under the state plan of at least $5,000,000, as a condition of receiving such payments:
(A) establish written policies for all employees of the entity (including management), and of any contractor or agent of the entity, that provide detailed information about the False Claims Act established under sections 3729 through 3733 of title 31, United States Code, administrative remedies for false claims and statements established under chapter 38 of title 31, United States Code, any state laws pertaining to civil or criminal penalties for false claims and statements, and whistleblower protections under such laws, with respect to the role of such laws in preventing and detecting fraud, waste, and abuse in Federal health care programs (as defined in section 1128B(f));
(B) include as part of such written policies, detailed provisions regarding the entity’s policies and procedures for detecting and preventing fraud, waste, and abuse; and
(C) include in any employee handbook for the entity, a specific discussion of the laws described in subparagraph (A), the rights of employees to be protected as whistleblowers, and the entity’s policies and procedures for detecting and preventing fraud, waste, and abuse.


Qui tam lawsuits can be filed by whistleblowers under certain state false claims laws if the fraud involves Medicaid funds or money from state and local agencies. In order for whistleblowers to receive a reward for their contributions to the recovery of state funds, most states that have whistleblower laws require the whistleblower to bring a qui tam lawsuit against the company.

Click the following links to state laws with qui tam provisions:

Minnesota
New Hampshire
New Jersey
New York
Rhode Island
South Carolina
Texas
Virginia
Wisconsin