AB 1186

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.