Colorado Medicaid False Claims Act allows private persons to file a qui tam action on behalf of the State government and recover 15-30% of the proceeds
An individual may bring a civil action for a violation of the Colorado Medicaid False Claims Act on behalf of the state. In a successful qui tam case, the whistleblower is entitled to between 15-30% of the proceeds recovered and collected in the action; plus reasonable expenses, attorney’s fees, and costs of the case.
Whistleblowers reporting fraud against the state of Colorado are protected against retaliation under the statute.
The Colorado Medicaid False Claims Act –Section 25.5-4-303.5 to 25.5-4-310– provides liability for any person who:
- Knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval;
- Knowingly makes, uses, or causes to be made or used a false record or statement material to a false or fraudulent claim;
- Has possession, custody, or control of property or money used, or to be used, by the state in connection with the “Colorado Medical Assistance Act” and knowingly delivers, or causes to be delivered, less than all of the money or property;
- Authorizes the making or delivery of a document certifying receipt of property used, or to be used, by the state in connection with the “Colorado Medical Assistance Act” and, intending to defraud the state, makes or delivers the receipt without completely knowing that the information on the receipt is true;
- Knowingly buys, or receives as a pledge of an obligation or debt, public property from an officer or employee of the state in connection with the “Colorado Medical Assistance Act” who lawfully may not sell or pledge the property;
- Knowingly makes, uses, or causes to be made or used, a false record or statement material to an obligation to pay or transmit money or property to the state in connection with the “Colorado Medical Assistance Act”, or knowingly conceals or knowingly and improperly avoids or decreases an obligation to pay or transmit money or property to the state in connection with the “Colorado Medical Assistance Act”;
- Conspires to commit a violation of paragraphs (a) to (f) of this subsection (1).
Violators are liable to the state for a civil penalty of $5,500 – $11,000, plus three times the amount of damages that the state sustains because of the act of that person.
