Revises provisions relating to Medicaid fraud. (BDR 18-446)

Existing law establishes the Medicaid Fraud Control Unit within the Office of the Attorney General as the agency responsible for the investigation and prosecution of violations or offenses relating to the State Plan for Medicaid. (NRS 228.410) In carrying out those duties and responsibilities, existing law authorizes the Attorney General, acting through the chief executive of the Medicaid Fraud Control Unit or his or her designee, to issue a subpoena for documents, records or materials. (NRS 228.411) Section 1 of this bill additionally authorizes such a subpoena to compel a person to: (1) appear and be examined under oath; and (2) answer written interrogatories under oath. Under section 1 the Attorney General is authorized to use any documents, records, materials, testimony or answers produced pursuant to such a subpoena in the course of a civil action involving Medicaid fraud, but prohibited from using those items in the course of a criminal action. Section 1 sets forth procedures by which the Attorney General may petition a court for the issuance of an order to compel compliance with such a subpoena. Existing federal law provides financial incentives for states that enact laws establishing liability for false or fraudulent claims made to the State Plan for Medicaid. (42 U.S.C. § 1396h) To be eligible for these financial incentives, the laws of a state must contain provisions that are at least as effective at rewarding and facilitating certain qui tam actions for false or fraudulent claims as those described in the federal False Claims Act. (31 U.S.C. §§ 3729-3732) Existing federal law prohibits a private person from bringing a qui tam action against a person for false or fraudulent claims if the action is based upon allegations or transactions which are the subject of a civil suit or an administrative civil money penalty proceeding in which the Federal Government is already a party. (31 U.S.C. § 3730(e)(3)) Existing state law contains similar provisions, but prohibits a private plaintiff from maintaining, rather than bringing, a qui tam action for false or fraudulent claims if the action is based upon allegations or transactions that are the subject of a civil action or administrative proceeding for a monetary penalty to which the State or political subdivision is already a party. (NRS 357.080) Section 2 of this bill revises that prohibition, consistent with federal law, to prohibit a person from bringing, rather than maintaining, such an action under those circumstances. Existing law makes it a gross misdemeanor for a person to intentionally fail to maintain certain records relating to a claim for payment for goods or services pursuant to the State Plan for Medicaid. (NRS 422.570) Section 3 of this bill instead makes the punishment for such an offense: (1) a misdemeanor if the amount of the claim was less than $650; and (2) a gross misdemeanor if the amount of the claim was $650 or more.