The Texas Medicaid Fraud Prevention Law applies only to false claims presented under the state’s Medicaid Act. “Qui Tam” suits may be brought by whistleblowers who discover that false claims have been presented to the Texas Medicaid program.
A successful whistleblower will receive between 15 and 25 percent of the proceeds in cases where the state intervenes; if the state does not intervene a successful whistleblower will receive between 25 and 30 percent of the proceeds. These amounts may be reduced if the whistleblower planned or initiated the violation.
Texas has a separate provision that allows for awards to individuals who report activities that constitute Medicaid fraud or abuse and whose information results in the recovery of an administrative penalty. The award may not exceed 5 percent of the penalty. A person who brings a “qui tam” action under the Medicaid Fraud Prevention Law is not eligible for an award under this section.
Read the full text of the law here.