SB 374

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 provides, as did the law before

2015 Wisconsin Act

55

took effect, 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 the extent of the individual's contribution to 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.