This bill proposes significant amendments to the Code of West Virginia, specifically focusing on the Medicaid program's fraud and abuse provisions by introducing a new False Claims Act. It establishes clear definitions and guidelines regarding false claims, detailing the responsibilities of the Attorney General and the rights of private individuals to initiate civil actions as qui tam plaintiffs. Key provisions include the establishment of treble damages for knowingly presenting false claims, the Attorney General's authority to investigate and prosecute violations, and a structured process for private individuals to bring actions on behalf of the state. The bill also allows the court to stay discovery for up to 60 days if it interferes with ongoing state investigations and permits the state to pursue alternate remedies, including administrative proceedings.

Furthermore, the legislation introduces limitations on civil actions, barring claims based on information already known to the state or those initiated by certain individuals, such as state employees or inmates. It clarifies that the state is not liable for expenses incurred by private litigants and includes provisions for private actions against retaliatory conduct. The bill emphasizes a liberal construction to promote public interest and outlines the distribution of proceeds from successful claims, ensuring that funds are allocated to support various state programs, including education and mental health services. Overall, the bill aims to enhance accountability and deter fraudulent claims within the Medicaid program while providing a structured enforcement process.

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