On November 13, 2019, the US Department of Justice announced that the Louisiana Department of Health has settled claims that it submitted “false and inflated Medicaid claims for long-term nursing home and hospice care” for $13,422.550. The Assistant US Attorney General said that the Department of Justice’s Civil Division, which handles cases for reimbursement due to fraud (based on the Federal Claims Act and other laws) “will take whatever steps are appropriate in our effort to protect federal healthcare programs, including Medicaid, from false claims.”


The Louisiana Department of Health did not admit liability as part of the settlement which involved the US Justice Department, the US Attorney’s Office for the Middle District of Louisiana, and the US Department of the Health and Human Services Office of Inspector General (HHS-OIG).


Medicaid is a joint state and federal healthcare program which provides financial help to people with low incomes – so they can get the medical help they need.


Typically nursing homes and hospices submit their claims for Medicaid payments to Louisiana on the 10th day of the month the services are provided. The Louisiana Department of Health pays these claims and then seeks reimbursement from the federal government – based on the rate in effect at the time of submission.


The US government claimed that the Louisiana Department of Health (LDH) was aware that the Medicaid payments rates were due to decrease “following the months of December 2010, March 2011, June 2011, and September 2013.”


To make sure they received the higher federal rates, the LDH “fraudulently caused its healthcare contractor, Molina Medical Solutions, to prepare, submit, and pay claims for nursing home and hospice services in these months, before the providers had submitted to Louisiana any claims for them.”


At the California Law Offices of Stephen Danz and Associates, we advise whistleblowers on their rights to file claims under the False Claims Act for all types of fraud involving Medicare, Medicaid, and other federal healthcare programs such as TRICARE – along with fraud involving other agencies. To learn if you have a viable whistleblower claim and how to handle it so you may be eligible for a percentage of any recovery, call us at 877-789-9707 or use our online contact form to make an appointment.