The False Claims Act exists to prevent fraud and protect taxpayer dollars. Both federal and state laws are in place to stop abuse within programs like Medicare and Medicaid. Even with these laws, fraud continues. That’s where whistleblowers come in. These are individuals who witness fraud and choose to come forward. If you suspect healthcare fraud in Arkansas, talk to an experienced healthcare whistleblower lawyer to understand your rights and potential rewards.
Arkansas and Federal False Claims Laws
Fraudulent healthcare claims are governed by both federal and state laws:
Federal Law
The United States False Claims Act (31 U.S.C. §§ 3729–3733) allows private citizens to sue on behalf of the government if they have knowledge of fraud involving federal funds. This is known as a qui tam lawsuit. If successful, whistleblowers may receive 15 to 30 percent of the recovered funds. Because these cases involve strict procedures, having a knowledgeable attorney is essential.
Arkansas Law
Arkansas enforces the Arkansas Medicaid False Claims Act (Ark. Code Ann. §§ 20-77-901 to 20-77-911). This law targets fraud against the state Medicaid program. Like the federal version, it allows private citizens to file civil suits and offers financial rewards. Penalties include up to $10,000 per false claim, plus triple the damages.
The law also protects whistleblowers from employer retaliation. If you report fraud in good faith, you are protected under Arkansas law.
What Is “Qui Tam”?
The term “qui tam” is short for a Latin phrase meaning “he who sues for the king as well as for himself.” In modern terms, it refers to a legal process where private individuals bring lawsuits on behalf of the government. These individuals, known as relators, may receive a percentage of any recovered money. These cases must be handled properly to qualify for rewards and legal protections, so it is important to seek legal advice before taking action.
Recent Healthcare Fraud Cases in Arkansas
Preferred Family Healthcare Settlement – Preferred Family Healthcare, a behavioral health provider, paid over $8 million to settle allegations of Medicaid fraud. The company was accused of improper billing and kickback schemes. A former employee filed the whistleblower claim and received a share of the recovery.
Arkansas Doctor Sentenced for $12 Million TRICARE Fraud Scheme – In April 2023, Dr. Joe David “Jay” May, a physician from Alexander, Arkansas, was sentenced to 102 months (over 8 years) in federal prison for his central role in a $12 million scheme defrauding TRICARE, the healthcare program for U.S. military personnel and their families.
Regions in Arkansas Prone to Healthcare Fraud
Certain cities and regions may see more cases due to population size, healthcare infrastructure, and billing volume:
Little Rock – The capital city and a hub for hospitals and state healthcare programs
Fort Smith – Home to large clinics and specialty practices
Fayetteville and Springdale – Rapid growth has increased oversight needs
Jonesboro – Serves surrounding rural communities with limited access to care
Pine Bluff – Long-term care facilities in the area have been under investigation
What To Do If You Suspect Healthcare Fraud in Arkansas
If you have evidence of Medicaid or Medicare fraud:
- Speak with a whistleblower attorney who understands the False Claims Act and Arkansas-specific rules.
- Do not discuss your concerns with coworkers or supervisors before speaking with a lawyer.
- Preserve all relevant records such as billing data, emails, and notes.
- Understand your rights under both state and federal law, including the potential to receive a financial reward and protection from retaliation.
Note: While this guide focuses on Arkansas, the same legal protections and options apply to whistleblowers across the United States.