Oklahoma Medicaid False Claims Act

The Oklahoma Medicaid False Claims Act (“Oklahoma Medicaid FCA”) provides severe penalties for individuals who submit false claims to SoonerCare (Oklahoma’s Medicaid program). It also provides powerful incentives and protections for private individuals with knowledge of Medicaid fraud to pursue claims on the State’s behalf.

The Oklahoma Legislature adopted the Oklahoma Medicaid FCA in May 2007 with an effective date on November 1, 2007.[1] The Oklahoma Medicaid FCA prohibits the submission of false claims to SoonerCare, the creation of false records related to false claims, and similar misconduct.[2] The Oklahoma Medicaid FCA can be utilized with respect to nearly all types of Medicaid fraud. Medicaid fraud can take several forms. For example, typical schemes including billing for services that are not provided, billing for medically unnecessary services, upcoding, double-billing, and kickbacks.[3]

Oklahoma False Claims Act Penalties

A person or entity who violates the Oklahoma Medicaid FCA is subject to significant penalties, including triple the amount of actual damages caused by the violations and a penalty of between $11,181 and $22,363 for each false claim.[4] Given that Medicaid fraud schemes typically involve a large number of false claims, these penalties can quickly add up.

Medicaid Fraud Whistleblower

Under the Oklahoma Medicaid FCA, individuals with knowledge about Medicaid fraud can bring a claim on the State’s behalf.[5] These individuals are typically known as qui tam relators or whistleblowers. After a lawsuit is filed, the State will investigate the claims and determine whether to formally participate in the lawsuit, which is known as intervention. If the State does not intervene, then the whistleblower may proceed with the claims on the State’s behalf.[6]

Medicaid Whistleblower Reward

If the lawsuit results in a recovery for the State, the whistleblower is entitled to receive a substantial portion (between 15-30% depending on various factors) of the recovery.[7] Given that the penalties under the Oklahoma Medicaid FCA are very significant as described above, a whistleblower stands to gain a substantial amount of money for bringing a successful lawsuit.

Whistleblower Protection

In addition, the Oklahoma Medicaid FCA creates important employment protections for whistleblowers. Specifically, the Oklahoma Medicaid FCA provides that if an employer retaliates against an employee for any “lawful acts done by the employee. . .  in furtherance” of a lawsuit under the Oklahoma Medicaid FCA or for  any “other efforts to stop one or more violations” of the Oklahoma Medicaid FCA, the employee is entitled to recover “all relief necessary.”[8] This includes reinstatement, double back pay, interest on back pay, and other damages resulting from any retaliation.[9]

Contact Us to Learn More

Do you need a Whistleblower Lawyer or want to know more information about Qui Tam Law and your rights under the False Claims Act?

There are three easy ways to contact our firm for a free, confidential evaluation with one of our whistleblower attorneys:

1. Fill out the contact form on this page.
2. Email [email protected]
3. Call (844) 781-3088

Your submission will be reviewed by a Berger Montague qui tam attorney and remain confidential.

[1] See PUBLIC HEALTH AND SAFETY—OKLAHOMA MEDICAID FALSE CLAIMS ACT, 2007 Okla. Sess. Law Serv. Ch. 137 (S.B. 889) (May 14, 2007).

[2] Okla. Stat.. tit. 63, § 5053.1.

[3] Ok. Att’y General, Medicaid Fraud Control Unit, available at http://www.oag.ok.gov/medicaid-fraud-unit#faq.

[4] Okla. Stat.. tit. 63, § 5053.1(B).

[5] Okla. Stat.. tit. 63, § 5053.2(B).

[6] Okla. Stat.. tit. 63, § 5053.2(B)(4).

[7] Okla. Stat.. tit. 63, § 5053.2(A).

[8] Okla. Stat.. tit. 63, § 5053.6(E)(1).

[9] Okla. Stat.. tit. 63, § 5053.6(E)(2).