The data reported between 2010 through 2019 by the State Attorney General under New Jersey’s False Claims Act (NJFCA) shows that the state netted $147 million under the NJFCA. The whistleblowers, also referred to as relators, received $8.8 million.
In January 2008, New Jersey joined 20 other states and the District of Columbia in passing its own civil false claims act. The NJFCA, modeled under the federal False Claims Act, allows whistleblowers to sue businesses and individuals who submit false or fraudulent claims for payment to the State. In return for filing under NJFCA, successful whistleblowers receive a share of the State’s recovery.
In 2010, the NJFCA was amended to require annual reporting by the State Attorney General to the State Legislature. The report includes data on new filings and settlements under the NJFCA from the previous year. Specifically, the reports track who is filing suit (the Attorney General or private individuals), the venue (state or federal court), and how much the State netted from settlements under the NJFCA.
Findings of the data collected from 2010 through 2019 include:
- There have been 915 cases filed under the NJFCA since 2010. The Attorney General filed 9 cases and private individuals filed 906 cases.
- Data from cases no longer under seal shows that whistleblowers filed 406 federal court cases and six state court cases. It appears that 19 NJFCA cases were redundant to other allegations brought under the federal False Claims Act or another state’s False Claims Act.
- NJFCA lawsuits had 405 cases involving Medicaid funds and 17 cases involving other State programs.
The decade of data suggests that the NJFCA has produced financial gains for New Jersey. The State’s judicial and prosecutorial investment has been negligible, with private individuals having filed nearly 99% of all NJFCA cases in federal court.
The individual Attorney General reports under N.J.S.A. § 2A:32C-18 can be accessed at: 2010-2019-NJ-AG-Report-on-FCA.pdf (falseclaimsact.com).
Issue:
It is extremely important that all members of the healthcare team are aware of what may be considered a false claim or a kickback. Ensure that all staff are aware that these violations can occur whether they are intentional or unintentional. Failure to promptly report a false claim or kickback can result in lawsuits, fines, and other sanctions. Additional information is available in the Med-Net Corporate Compliance and Ethics Manual, Chapter 1 Compliance and Ethics Program, CP 2.3 General Legal Duties and Antitrust Laws.
Discussion Points:
- Review policies and procedures for preventing and reporting a false claim or anti-kickback statute violation. Update your policies and procedures as needed.
- Train all staff on the False Claims Act and Anti-Kickback Statute and what can be considered a false claim or kickback. Include information on how to report concerns and suspected violations, and that prompt reporting is mandatory. Document that the trainings occurred and place in each employee’s education file.
- Periodically audit staff understanding to ensure that they are aware of what should be done if they suspect a false claim or illegal kickback has occurred, whether intentionally or unintentionally. Conduct audits of documentation and billing routinely to prevent and detect errors before they progress to a false claim.
