Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth
	MassHealth
	All Provider Bulletin 162
	December 2006




	TO:	All Providers Participating in MassHealth

	FROM:	Beth Waldman, Medicaid Director

	RE:	Employee Education about False Claims 


New Federal Requirement
	This is to inform you about a federal law that becomes effective 
	January 1, 2007, and requires all entities that receive at least five million 
dollars in Medicaid payments annually to educate employees about 
federal and state laws concerning false claims and whistleblower 
protections.  The new law requires that as a condition of receiving such 
payments, the entity:

* establish written policies for all employees of the entity (including 
management), and for all employees of any contractor or agent, that 
provide detailed information about federal and state false claims laws, 
penalties for submitting false claims and statements, whistleblower 
protections, and the role of the laws in preventing and detecting fraud, 
waste, and abuse;  
* include as part of such written policies detailed information about the 
entity’s policies and procedures for detecting and preventing fraud, 
waste, and abuse; and
* include in any employee handbook a specific discussion of the laws, 
whistleblower protections, and the entity’s policies and procedures for 
detecting fraud, waste, and abuse.
	
	Attached for your reference is a copy of Section 6032 of the Deficit 
Reduction Act of 2005, which specifies the new federal requirements.  For 
further information, please see the State Medicaid Director Letter (SMDL 
# 06-024) regarding  Employee Education about False Claims, dated 
December 13, 2006, on the federal Centers for Medicare and Medicaid 
Services Web site (CMS.gov).    
  

			MassHealth
			All Provider Bulletin 162
			December 2006
			Attachment 

SEC. 6032. EMPLOYEE EDUCATION ABOUT FALSE CLAIMS 
RECOVERY.
(a) In General- Section 1902(a) of the Social Security Act (42 U.S.C. 
1396a(a)) is amended--
(1) in paragraph (66), by striking `and' at the end;
(2) in paragraph (67) by striking the period at the end and 
inserting `; and'; and
(3) by inserting after paragraph (67) the following:
`(68) provide that any entity that receives or makes annual 
payments under the State plan of at least $5,000,000, as a 
condition of receiving such payments, shall--
`(A) establish written policies for all employees of the 
entity (including management), and of any contractor or 
agent of the entity, that provide detailed information 
about the False Claims Act established under sections 
3729 through 3733 of title 31, United States Code, 
administrative remedies for false claims and statements 
established under chapter 38 of title 31, United States 
Code, any State laws pertaining to civil or criminal 
penalties for false claims and statements, and 
whistleblower protections under such laws, with respect 
to the role of such laws in preventing and detecting fraud, 
waste, and abuse in Federal health care programs (as 
defined in section 1128B(f));
`(B) include as part of such written policies, detailed 
provisions regarding the entity's policies and procedures 
for detecting and preventing fraud, waste, and abuse; 
and
`(C) include in any employee handbook for the entity, a 
specific discussion of the laws described in subparagraph 
(A), the rights of employees to be protected as 
whistleblowers, and the entity's policies and procedures 
for detecting and preventing fraud, waste, and abuse.'.
(b) EFFECTIVE DATE- Except as provided in section 6035(e), the 
amendments made by subsection (a) take effect on January 1, 2007.