April 9, 2024 - Introduced by Representatives Subeck, Ratcliff and Palmeri, cosponsored by Senator Smith. Referred to Committee on Judiciary.
AB1186,,22An Act to renumber and amend 49.485; to amend 801.02 (1), 803.09 (1), 803.09 (2), 804.01 (2) (intro.) and 805.04 (1); and to create 20.9315, 49.485 (1), 165.25 (11m), 805.04 (2p) and 893.9815 of the statutes; relating to: restoring private individual authority to bring a qui tam claim against a person for making a false claim for medical assistance, actions by the attorney general against a person for making a false claim for medical assistance, and providing a penalty. AB1186,,33Analysis by the Legislative Reference Bureau This bill restores a private individual’s authority to bring a qui tam claim against a person who makes a false claim for medical assistance, which was eliminated in 2015 Wisconsin Act 55. A qui tam claim, as it relates to the Medical Assistance program under the bill, is a claim initiated by a private individual on his or her own behalf and on behalf of the state against a person who makes a false claim for medical assistance. The bill restores the language prior to the enactment of 2015 Wisconsin Act 55 that stated that, of moneys recovered as a result of a qui tam claim, a private individual may be awarded up to 30 percent of the amount recovered, depending upon certain factors, including the individual’s role in advancement of the prosecution of the action. The individual may also be entitled to reasonable expenses incurred in bringing the action, as well as attorney fees. This bill also includes additional changes not included in the prior law to conform state law to the federal False Claims Act, including expanding provisions to facilitate qui tam actions and modifying the bases for liability to parallel the liability provisions under the federal False Claims Act. In addition to qui tam claims, the Department of Justice has independent authority to bring a claim against a person for making a false claim for medical assistance. This bill modifies provisions relating to DOJ’s authority to parallel the liability and penalty standards relating to qui tam claims, specifically, applying the definition of the term “claim” and the forfeiture amounts provided under the federal False Claims Act. For further information see the state fiscal estimate, which will be printed as an appendix to this bill.
AB1186,,44The people of the state of Wisconsin, represented in senate and assembly, do enact as follows: AB1186,15Section 1. 20.9315 of the statutes is created to read: AB1186,,6620.9315 False claims for medical assistance; actions by or on behalf of state. (1) In this section: AB1186,,77(b) “Claim” has the meaning given in 31 USC 3729 (b) (2). AB1186,,88(d) “Knowingly” means, with respect to information, having actual knowledge of the information, acting in deliberate ignorance of the truth or falsity of the information, or acting in reckless disregard of the truth or falsity of the information. “Knowingly” does not mean specifically intending to defraud. AB1186,,99(de) “Material” means having a natural tendency to influence, or be capable of influencing, the payment or receipt of money or property. AB1186,,1010(dm) “Medical assistance” has the meaning given under s. 49.43 (8).