NICA will pay $51 million to resolve whistleblower claims.
The Florida Birth-Related Neurological Injury Compensation Plan and its administrator, the Florida Birth-Related Neurological Injury Compensation Association (NICA) has come under fire for improper Medicaid billing practices. NICA is an organization set up to care for infants born with brain or spinal-cord injuries. Lawmakers created NICA claims in 1988 as a no-fault system to pay for the care of children so long as the physicians participate in NICA and pay yearly assessments.
They have agreed to pay $51 million to settle allegations that they violated the False Claims Act (FCA) by causing NICA participants to submit their healthcare claims to Medicaid rather than NICA. This was found to be in violation of Medicaid’s status as the payer of last resort under federal law. The False Claims Act allows for legal action to be taken against individuals or companies that defraud the government.
This 2019 whistleblower lawsuit has led to a $51 Million FCA settlement. The whistleblower provisions of the False Claims Act allow a private party to file a lawsuit on the behalf of the United States. The qui tam provisions of the act enable private citizens to file lawsuits on behalf of the government if they know of an individual or company defrauding the government. Qui tam whistleblowers are eligible to receive between 15 and 30% of the government’s recovery if granted. This permits that private party to be able to receive a...
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