SS/SCS/SB 639 - This act provides that any person may bring an action for MO HealthNet fraud on behalf of the person and the state. The person bringing the action must give a copy of the petition to the attorney general, and must also disclose to the attorney general all material information in the person’s possession. The petition shall be filed in camera, and shall remain under seal for at least 60 days, or until the state elects to intervene, whichever occurs first. Service of the petition shall not be made on the defendant until ordered by the court. On behalf of the state, the attorney general may elect to intervene and proceed with the action, not later than 60 days after the date the attorney general received the petition and information. This deadline may be extended for good cause shown.
The court and the attorney general may consent to a dismissal of an action at any time during which the petition remains under seal. If the state elects not to intervene, the person bringing the action shall have the right to proceed with the action.
No person other than the state may intervene or bring a related action based on the same underlying facts as an action brought under this section. If the state intervenes, it shall have the primary responsibility for investigating and prosecuting the action, and is not bound by any act of the person bringing the action. Such person shall have the right to continue as a party to the action, subject to limitations.
The state may limit the participation of the person who initiated the action if it finds that the person’s participation would cause harassment, or would unduly delay investigation or prosecution of the action, or would be repetitious or irrelevant. Limitations may include, but are not limited to, limiting the number of witnesses, limiting length of testimony, and limiting cross-examination of witnesses.
Even if an action has been brought under this act, the state is free to pursue the claim through any alternate proceeding. The person bringing the initial action will have the same rights in an alternate proceeding as are provided by this act, and any final finding or conclusion in the alternate proceeding shall be conclusive on all parties to the initial action.
If the state proceeds with an action, the person who initiated the action is entitled to at least fifteen percent of the proceeds of any action brought under this section and at least twenty-five percent of the proceeds if the state does not proceed, unless the court finds that the action is based primarily on information not provided by the person initiating the action, in which case the court shall award the person no more than fifteen percent of the proceeds. If the court finds that the person bringing the action planned and initiated the violation on which the action is based, it may reduce the share of the proceeds to the extent it deems appropriate. However, any person convicted of a violation shall not be entitled to any share of the proceeds, and shall be dismissed from the action.
A person may not bring an action under this act that is based on allegations that are the subject of another civil suit or administrative penalty proceeding which has already commenced, and in which the state is a party.
A person may not bring an action under this act that is based on the public disclosure of allegations or transactions in a criminal or civil hearing, in a legislative or administrative report, hearing, audit, or investigation, or from the news media, unless the person bringing the action is the original source of such information.
An action brought under this section shall not be brought more than six years after the date on which the violation was committed, or three years after the date when facts material to the cause of action are known or reasonably known by the attorney general's office or the department of social services, whichever occurs last.
This act also modifies the definition of "knowingly" as it relates to MO HealthNet fraud civil liability to provide that no proof of specific intent to defraud is required.
ADRIANE CROUSE