HB39 Alabama 2016 1st Special Session Session

Existing law does not provide a specific remedy for the state to pursue damages sustained when a person or entity commits false or fraudulent acts against the state

This bill would establish the Alabama Medicaid False Claims Act, to provide a remedy for fraudulent claims in the Alabama Medicaid program

This bill would provide that certain persons who make false claims or commit fraud against the Medicaid program would be liable to the state for three times the amount of damage sustained, a civil penalty, and any associated costs, including attorneys' fees

This bill would provide for the responsibilities of the Attorney General and private individuals in investigating and proceeding against violators in civil actions

This bill would prohibit any employer from taking retaliatory action or preventing an employee from disclosing information to government or law enforcement agencies investigating false or fraudulent claims actions

This bill would also provide for the limitation of actions

Also under existing law, criminal penalties are provided for receiving certain remuneration for certain referrals for Medicaid payments or in return for purchasing, leasing, ordering, or arranging certain goods or services to be paid by Medicaid

This bill would provide that a person must knowingly engage in the prohibited conduct in order to be subject to the criminal penalties, would provide that the criminal penalties do not apply to certain safe harbor exceptions included in federal law, would define a person to include a corporation or other business entity, and would provide for a six-year statute of limitations for prosecution of the offenses

Amendment 621 of the Constitution of Alabama of 1901, now appearing as Section 111.05 of the Official Recompilation of the Constitution of Alabama of 1901, as amended, prohibits a general law whose purpose or effect would be to require a new or increased expenditure of local funds from becoming effective with regard to a local governmental entity without enactment by a 2/3 vote unless: it comes within one of a number of specified exceptions; it is approved by the affected entity; or the Legislature appropriates funds, or provides a local source of revenue, to the entity for the purpose

The purpose or effect of this bill would be to require a new or increased expenditure of local funds within the meaning of the amendment. However, the bill does not require approval of a local governmental entity or enactment by a 2/3 vote to become effective because it comes within one of the specified exceptions contained in the amendment

Relating to Medicaid fraud; to create the Alabama Medicaid False Claims Act, relating to false or fraudulent claims made upon the Alabama Medicaid program; to subject certain violators making false claims or committing fraud against the Alabama Medicaid Agency to treble damages and civil penalties; to provide for associated investigative costs; to provide for exceptions; to provide for the responsibilities of the Attorney General and private individuals in investigating and proceeding against violators in civil actions; to prohibit retaliatory actions by employers against employees who disclose information to government or law enforcement agencies investigating false claims; to provide for the limitation of actions; to amend Section 22-1-11, Code of Alabama 1975, relating to false statements or claims on applications for payment of medical benefits from the Medicaid Agency, to provide that a person must knowingly engage in the conduct in order to be subject to the criminal penalties; to provide that the criminal penalties do not apply to certain activity excepted by federal law; to provide for a six-year statute of limitations; to define person to include business entities; and in connection therewith would have as its purpose or effect the requirement of a new or increased expenditure of local funds within the meaning of Amendment 621 of the Constitution of Alabama of 1901, now appearing as Section 111.05 of the Official Recompilation of the Constitution of Alabama of 1901, as amended.