Four State Medicaid Fraud Statutes Provide Whistleblowers with Additional Remedies and Protections
When a whistleblower uncovers Medicaid fraud, federal and state False Claims Act statutes can remedy the fraud and protect whistleblowers. But only 29 states have these statutory protections. However, four states have Medicaid-only statutes to allow whistleblowers to report fraud and receive some protections. But how effective are these Medicaid-only laws? Let’s look at the numbers.
Washington, Louisiana, Michigan, and Texas have state Medicaid-only laws, providing a path to report state Medicaid fraud. These Medicaid fraud laws are less frequently used than state false claims act laws but still provide an avenue for would-be whistleblowers to report Medicaid fraud.
Washington’s Medicaid Fraud False Claims Act has many procedural similarities to the federal FCA.[1] From 2016 to 2022, 19 state cases were filed, resulting in three settled cases, one litigated case, 8 declined cases and 7 cases then still under investigation.[2] During this timeframe, the Attorney General spent $4 million investigating cases and recovered $71.8 million between its own statute and multistate cases in which it participated.[3] Washington resolved its second-largest Medicaid fraud recovery in August, 2022, with Centene Corporation for $19.9 million over whistleblower allegations that Centene overcharged Washington for pharmacy benefits management. [4]
The Louisiana Medical Assistance Programs Integrity Law allows whistleblowers to file qui tam cases involving fraud against all Louisiana medical assistance programs, including Medicaid.[5] The statute also offers employment protections, similar to those in the federal FCA.[6] In 2013, Louisiana, under the Medical Assistance law and its Unfair Trade Practices law, recovered $88.4 million from pharmaceutical companies accused of fraudulently inflating the price of drugs sold to the Medicaid program.[7] While the state House considers removing the qui tam law’s whistleblower provisions[8], the state Senate is proposing to increase funding for investigations into Medicaid fraud.[9] Louisiana recently shared in a federal settlement alleging kickbacks by a pharmaceutical company, with Louisiana receiving $1.1 million of a $49 million recovery.[10]
The Michigan Medicaid False Claims Act, penalizes those who: (1) falsely apply for Medicaid benefits, (2) offer, solicit or receive kickbacks related to furnishing Medicaid goods or services (3) make false statements about the condition or operations of a facility receiving Medicaid payments, (4) aid or abet false claims, (5) or make or present false claims, records or statements.[11] Michigan’s law also provides employment protections similar to the federal FCA.[12] In January 2025, Michigan recovered $1 million from a $4.5 million federal settlement against a Detroit area nursing home chain over allegations of chronic neglect.[13]
The Texas Medicaid Fraud Prevention Act (“TMFPA”),[14] allows private persons to bring civil actions for violations of the Medicaid Fraud Prevention Act.[15] The Act also provides employment retaliation protections.[16] Texas’ law is extremely active and frequently partners with federal investigations to recover Medicare fraud funds. As of August 2023, Texas reported that its Medicaid Fraud division had recovered over $2 billion since 2000.[17] Texas reported in 2023 that for every dollar it spent in state funding, it recovers more than $33 for taxpayers.[18] In 2025, Texas touted a $42.7 million recovery in a matter brought under the TMFPA.[19]
As the numbers show, states that have Medicaid-only fraud laws still reward whistleblowers for doing the right thing.
[1] R.C.W. Title 74.66.
[2] Joint Legis. Audit & Rev. Comm., 22-04 Final Report: Sunset Review of Medicaid Fraud Qui Tam Provisions [hereinafter JLARC Report].
[4] Press Release, Washington State Office of the Attorney General, AG Ferguson: Health care giant Centene to pay Washington $19 million for overcharging state Medicaid program in 2nd largest Medicaid fraud recovery in WA history | Washington State (Aug. 24, 2022).
[5] LA Rev. Stat. §46:439.1.
[6] LA Rev. Stat. §46:440.3.
[7] See, Louisiana settles Medicaid Fraud litigation for $88.4 million*
[8] CitizenPortal.ai – Louisiana lawmakers propose repeal of Medicaid fraud whistleblower protections
[9] S.B. No. 130, SLS 25R20-367 (La. 2025).
[10] Press Release, Attorney General Murrill secures over $200 million from Gilead Sciences for paying Illegal Kickbacks, Louisiana Dep’t of Just. (last accessed Aug. 11, 2025).
[11] M.C.L. §400.601 et seq.
[12] M.C.L. § 400.610c.
[13] Press Release, Mich. Dep’t of Att’y Gen., Attorney General: Attorney General Nessel Announces $4.5 Million Settlement with Detroit Nursing Homes Over Substandard Care Allegations (July 2, 2025).
[14] Tex. Hum. Res. Code §36.101.
[15] Tex. Hum. Res. Code §36.002 et seq.
[16] Tex. Hum. Res. Code §36.115.
[17] Press Release, Att’y Gen. of Tex., Office of the Attorney General’s Civil Medicaid Fraud Division Recovers $42.7 Million in Taxpayer Funds, (Aug. 8, 2023).
[18] Press Release, Att’y Gen. of Tex., Texas Attorney General’s Medicaid Fraud Control Unit Helps Take Down $6.9 Million Medicaid Fraud Scheme, (June 29, 2023).
[19] Press Release, Att’y Gen. of Tex., Office of the Attorney General’s Civil Medicaid Fraud Division Recovers $42.7 Million in Taxpayer Funds | Office of the Attorney General (Aug. 8, 2023).
This piece was written by Regina “Gina” Poserina, Of Counsel at Costello & Silverman.
