The Office of Inspector General (“OIG”) recently determined that Louisiana’s Medical Assistance Programs Integrity Law (“MAPIL”) does not meet certain requirements outlined in Section 6031 of the Deficit Reduction Act of 2005 (“DRA”). Section 6031 of the DRA provides a financial incentive to states who enact laws that establish liability to the state for individuals and entities that submit false or fraudulent claims to the state Medicaid program, if the state’s law satisfies certain requirements outlined in the DRA. If the Office of Inspector General (“OIG”) determines that a state false claims act meets the enumerated criteria under the DRA, then the state will receive a 10-percent increase in its share of Medicaid fraud recoveries from state actions brought under the state act. To date, the OIG has reviewed laws enacted in 10 states and determined that seven states’ laws, including MAPIL, do not comply with the DRA requirements.

In a letter to the Assistant Attorney General at the Louisiana Department of Justice dated December 21, 2006, the OIG stated that MAPIL does not meet the requirements of sections 6031(b)(2) and (4) of the DRA. Section 6031 (b)(2) requires a state law to contain provisions that are at least as effective as the Federal False Claims Act, 31 U.S.C. § § 3730-3732, in rewarding and facilitating qui tam actions. In their review, the OIG determined that MAPIL did not satisfy the requirements of subsection (b)(2) in two regards. First, unlike its federal counterpart, MAPIL does not contain a provision to allow the State to intervene in an action at a later date upon a showing of good cause. Second, in cases where the State does intervene, the private individual who filed the suit (known as the relator) may only recover between 10 and 20 percent of the recovery. In Federal cases where the Federal government intervenes, the relator may recover between 15 and 25 percent. Consequently, the OIG found that the State law was not as effective as the Federal False Claims Act in rewarding qui tam actions.

The OIG also found that MAPIL did not satisfy the requirement of section 6031(b)(4) to contain a civil penalty equal to or greater than the civil penalty authorized under the Federal False Claims Act. While both the Federal False Claims Act and MAPIL contain a maximum penalty limit, the Federal act also contains a minimum penalty amount. Because MAPIL does not include a minimum limit, the OIG determined that the penalty authorized under the State law was not equal to or greater than that authorized by the Federal government.

Based on the OIG’s comments, it is likely that Louisiana will amend MAPIL to comply with the DRA requirements. The OIG has stated that if MAPIL is amended to address the issues above, then it will reconsider the law.