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42 U.S.C. § 1396hState false claims act requirements for increased State share of recoveries

submitted 91 years ago by Pub. L. 109-171 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 355 words · no verdicts yet

in plain englishAI-generated · not legal advice

If a State has a qualifying law against false or fraudulent claims, the Federal medical assistance percentage for amounts recovered under a State action using that law is reduced by 10 percentage points. The section lists requirements for the State law, preserves compliance for qualifying laws in effect on January 1, 2007, and allows broader laws.

(a) In general. Despite section 1396d(b) of this title, if a State has a law against false or fraudulent claims that meets subsection (b), the Federal medical assistance percentage for amounts recovered in a State action under that law is reduced by 10 percentage points. (b) Requirements. The Inspector General of the Department of Health and Human Services, consulting with the Attorney General, must determine that the State law has all of these features: (1) It makes a person liable to the State for false or fraudulent claims described in section 3729 of title 31 involving an expenditure described in section 1396b(a) of this title. (2) It has provisions at least as effective as the provisions in sections 3730 through 3732 of title 31 for rewarding and helping qui tam actions involving false or fraudulent claims. This section does not define “qui tam action.” (3) It requires an action to be filed under seal for 60 days while the State Attorney General reviews it. (4) It has a civil penalty at least as large as the civil penalty authorized by section 3729 of title 31. (c) Deemed compliance. A State whose law met subsection (b) on January 1, 2007, is treated as meeting those requirements for as long as its law continues to meet them. (d) Broader laws allowed. This section does not prohibit a State from being treated as meeting subsection (a)’s requirements when its law imposes liability for the claims described in section 3729 of title 31 involving programs beyond the State program under this subchapter or expenditures beyond those described in section 1396b(a) of this title, as long as the law meets the requirements in this section.
the actual law source: uscode.house.gov ↗public domain
(a) In general

Notwithstanding section 1396d(b) of this title, if a State has in effect a law relating to false or fraudulent claims that meets the requirements of subsection (b), the Federal medical assistance percentage with respect to any amounts recovered under a State action brought under such law, shall be decreased by 10 percentage points.

(b) Requirements

For purposes of subsection (a), the requirements of this subsection are that the Inspector General of the Department of Health and Human Services, in consultation with the Attorney General, determines that the State has in effect a law that meets the following requirements:

(1)

The law establishes liability to the State for false or fraudulent claims described in section 3729 of title 31 with respect to any expenditure described in section 1396b(a) of this title.

(2)

The law contains provisions that are at least as effective in rewarding and facilitating qui tam actions for false or fraudulent claims as those described in sections 3730 through 3732 of title 31.

(3)

The law contains a requirement for filing an action under seal for 60 days with review by the State Attorney General.

(4)

The law contains a civil penalty that is not less than the amount of the civil penalty authorized under section 3729 of title 31.

(c) Deemed compliance

A State that, as of January 1, 2007, has a law in effect that meets the requirements of subsection (b) shall be deemed to be in compliance with such requirements for so long as the law continues to meet such requirements.

(d) No preclusion of broader laws

Nothing in this section shall be construed as prohibiting a State that has in effect a law that establishes liability to the State for false or fraudulent claims described in section 3729 of title 31, with respect to programs in addition to the State program under this subchapter, or with respect to expenditures in addition to expenditures described in section 1396b(a) of this title, from being considered to be in compliance with the requirements of subsection (a) so long as the law meets such requirements.

Source credit: (Aug. 14, 1935, ch. 531, title XIX, § 1909, as added Pub. L. 109–171, title VI, § 6031(a), Feb. 8, 2006, 120 Stat. 72.)

history & why it existsrecord from the source credit
  • 1935Enacted · Pub. L. 109-171 · 120 Stat. 72

A history note hasn’t been published yet. The record shows enactment by Pub. L. 109-171 on 1935-08-14.

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