Non Retaliation Policy

Terrebonne General provides the following information about its policies and procedures and the role of certain federal and state laws to prevent and detect fraud, wastes and abuse in federal health care programs.

Federal False Claims Law

The federal False Claims Act imposes liability on any person or entity who:

Knowingly files a false or fraudulent claim for payments to Medicare, Medicaid or other federally funded health care program; or

Knowingly uses a false record or statement to obtain payment on a false or fraudulent claim from Medicare, Medicaid or other federally funded health care program; or

Conspires to defraud Medicare, Medicaid or other federally funded health care program by attempting to have a false or fraudulent claim paid.

A person or entity found liable under the False Claims Act is, generally, subject to civil money penalties of between $5,500 and $11,000 per claim plus three times the amount of damages that the government sustained because of the illegal act. In health cases, the amount of damages sustained is the amount paid for each claim that is filed that is determined to be false.

The law also provides employment protection for qui tam plaintiffs (whistleblowers) including reinstatement with seniority status, special damages, and double back pay.

The Program Fraud Civil Remedies Act (PFCRA) creates administrative remedies for making false claims and false statements. These penalties are separate from and in addition to any liability that may be imposed under the False Claims Act.

State False Claims Laws

LA False Claims Act, Act No. 1373

The state Medical Assistance Programs Integrity Law, Part VI-A, S 437.1

Intent and Purpose

Terrebonne General’s Policies and Procedures for Detecting and Preventing Fraud:

The organization uses many methodologies to prevent and detect fraud and abuse. The organizational compliance plan and policies and procedures describe processes used in prevention and detection of fraud and abuse.

Anti-Retaliation Protections

These private parties, known as “qui tam relators,” may share in a percentage of the proceeds from a FCA action or settlement.

No individual shall be threatened, harassed, or discriminated against in any manner by a health care provider or other person because of any lawful act engaged in by the individual or on behalf of the individual in furtherance of any action taken pursuant to this Part in regard to a health care provider or other person from whom recovery is or could be sought except that a health care provider may arrange for a recipient to receive goods, services, or supplies from another health care provider if the recipient agrees and the arrangement is approved by the secretary. Such an individual may seek any and all relief for his injury to which he is entitled under state or federal law.