The proposed bill seeks to establish a new False Claims Act in West Virginia, revising existing fraud and abuse provisions within the Medicaid program. It introduces civil penalties for individuals or entities that submit false claims, detailing the responsibilities of the Attorney General and outlining prohibited acts such as knowingly presenting false claims. The bill also sets forth a framework for civil actions, including qui tam proceedings, which allow private individuals to sue on behalf of the state. Key definitions are clarified, and the state’s conditions for intervening in private actions are specified. Additionally, the bill enhances penalties for fraudulent claims by implementing a tiered system of damages, including treble damages, and establishes a five-year statute of limitations for related civil actions.

Furthermore, the bill addresses the rights and responsibilities of qui tam plaintiffs, including the distribution of proceeds from successful actions to various state initiatives like education and mental health services. It emphasizes the protection of whistleblowers against retaliation and clarifies jurisdictional issues, the burden of proof, and the relationship between this act and other legal remedies. Overall, the bill aims to strengthen anti-fraud enforcement in the Medicaid program and provide a clearer legal framework for addressing false claims against the state.

Statutes affected:
Introduced Version: 9-7-6, 14-4-1, 14-4-2, 14-4-3, 14-4-4, 14-4-5, 14-4-6, 14-4-7, 14-4-8, 14-4-9, 14-4-10, 14-4-11, 14-4-12