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False Claims Act and Whistleblower Protection

VANDERBILT UNIVERSITY PEOPLE EXPERIENCE POLICIES AND PROCEDURES
SUBJECT: FALSE CLAIMS ACT AND WHISTLEBLOWER PROTECTION
EFFECTIVE DATE: July 1, 2015
UPDATED: June 1, 2023

POLICY STATEMENT/REASON FOR POLICY

The policy of Vanderbilt University is to require all employees to report all known or suspected violations of the Federal False Claims Act (“FFCA”), the Tennessee False Claims Act (“TFCA”), or the Tennessee Medicaid False Claims Act (“TMFCA”)_(collectively referred to as “FCA”), as described below.

THIS POLICY APPLIES TO

This policy applies to all staff.

POLICY

A person violates the FCA by knowingly submitting, or causing another to submit, false claims for payment of government funds. Examples of violations of a FCA are, but not limited to, (i) submission of a claim to Medicare for payment for services not rendered, or (ii) falsification of a time and effort report in connection with a claim for reimbursement from government grant. It is also the policy of Vanderbilt University that persons reporting such suspected violations (sometimes referred to as “whistleblowers”) will not be retaliated against (as defined in Section III. below) for making such reports in good faith.

FFCA (located at 31 U.S.C. §3729)

FFCA states, in part, that it is a violation of Federal law for any person to knowingly present, or cause to be presented, to the Federal Government a false or fraudulent claim for payment or approval or who knowingly makes or causes to be made a false record in order to get a false claim paid by the Federal Government.

More specifically, a person’s actions that can be found to be a violation of the FFCA include, but are not limited to:

  1. Knowingly presenting, or causing to be presented, a false or fraudulent claim for payment or approval;
  2. Knowingly making, using, or causing to be made or used, a false record or statement material to a false or fraudulent claim;
  3. Conspiring to get a false claim allowed or paid;
  4. Knowingly making, using, or causing to be made or used, a false record or statement material to an obligation to pay or transmit money or property to the government, or knowingly concealing or knowingly and improperly avoiding or decreasing an obligation to pay or transmit money or property to the government;
  5. Having possession, custody, or control of property or money used (or to be used) by the government and knowingly delivering (or causing to be delivered) less than all of that money or property;
  6. Being authorized to make or deliver a document certifying receipt of property used, or to be used, by the government and, intending to defraud the government, making or delivering the receipt without completely knowing that the information on the receipt is true; and
  7. Knowingly buying, or receiving as a pledge of an obligation or debt, public property from an officer or employee of the government who lawfully may not sell or pledge property.

A violation of the FFCA can result in a civil penalty of not less than $5,500 and not more than $11,000, plus 3 times the amount of damages sustained by the Federal Government.

TFCA (located at T.C.A. §4-18-103)

TFCA states, in part, that it is a violation of State law for any person to knowingly present to the State of Tennessee or political subdivision a false or fraudulent claim for payment or approval or who misappropriate state property, deceptively avoid binding obligations to pay the state, who knowingly makes or causes to be made a false record, among other violations in order to get a false claim paid by the State of Tennessee.

More specifically, a person’s actions that can be found to be in violation of the TFCA include, but are not limited to:

  1. Knowingly presents or causes to be presented to an officer or employee of the state or of any political subdivision thereof, a false claim for payment or approval;
  2. Knowingly makes, uses, or causes to be made or used a false record or statement to get a false claim paid or approved by the state or by any political subdivision;
  3. Conspires to defraud the state or any political subdivision by getting a false claim allowed or paid by the state or by any political subdivision;
  4. Has possession, custody, or control of public property or money used or to be used by the state or by any political subdivision and knowingly delivers or causes to be delivered less property than the amount for which the person receives a certificate or receipt;
  5. Is authorized to make or deliver a document certifying receipt of property used or to be used by the state or by any political subdivision and knowingly makes or delivers a receipt that falsely represents the property used or to be used;
  6. Knowingly buys, or receives as a pledge of an obligation or debt, public property from any person who lawfully may not sell or pledge the property;
  7. Knowingly makes, uses, or causes to be made or used a false record or statement to conceal, avoid, or decrease an obligation to pay or transmit money or property to the state or to any political subdivision;
  8. Is a beneficiary of an inadvertent submission of a false claim to the state or a political subdivision, subsequently discovers the falsity of the claim, and fails to disclose the false claim to the state or the political subdivision within a reasonable time after discovery of the false claim; or
  9. Knowingly makes, uses, or causes to be made or used any false or fraudulent conduct, representation, or practice in order to procure anything of value directly or indirectly from the state or any political subdivision.

A violation of the TFCA can result in a civil penalty of not less than $2,500 and not more than $10,000 for each false claim, plus 3 times the amount of damages sustained by the State or political subdivision. Unlike the FFCA, it is a violation of the TFCA for a person to make an inadvertent submission of a false claim and, later, fail to disclose or report the inadvertent submission after discovering the error.

TMFCA (located at TCA §71-5-183)

The Tennessee Medicaid False Claims Act (TMFCA) allows civil and/or administrative actions to be brought against any person7 who:

  1. Knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval under the Medicaid program;
  2. Knowingly makes, uses, or causes to be made or used, a false record or statement material to a false or fraudulent claim under the Medicaid program;
  3. Knowingly makes, uses, or causes to be made or used, a false record or statement material to an obligation to pay or transmit money or property to the state, or knowingly conceals, or knowingly and improperly, avoids or decreases an obligation to pay or transmit money or property to the state relative to the Medicaid program; or
  4. Conspires to commit a violation of the above subsections numbered 1-3.8

A violation of the TMFCA may impose fines that shall be not less than $5,000 and not more than $25,000, plus three times the amount of damages which the state sustains because of the act of that person.

Reporting a Known or Suspected Violation of FFCA or TFCA

1.    An employee is expected to report any known or suspected violation of either the FFCA or the TFCA to the employee's supervisor, department head or chair, the University Compliance Officer, or to the 24-hour Confidential Help Line for the University at (866) 783-2287.

a.    In making reports to the Confidential Help Line, the caller may make a report anonymously. The compliance helplines have no call identification or number recognition capability.

2.    An employee may also report known or suspected violations of the FFCA to the OIG hotline, (800) 424-5197, by email at hotline@oig.doc.gov, or visit the website at https://www.oig.doc.gov. 

3.    All persons making reports of compliance concerns are assured that such reports will be considered confidential to the extent permitted by law. Such reports will be shared with others only on a bona fide need to know basis.

Whistleblower Protection

Vanderbilt prohibits retaliation and will take no adverse action against persons for making such reports in good faith (“whistleblowers"), even if the report turns out not to be correct. Retaliation and adverse action include, but may not be limited to, the following: discharge, demotion, suspension, harassment, denial of promotion, denying of benefits or overtime, making threats, reducing hours, constructive discharge, transfer or in any other manner discriminating or threatening to discriminate against a staff member in the terms and conditions of the employee’s employment. Any employee who believes that he or she has been subjected to or affected by a retaliatory conduct for reporting a suspected violation of a FCA or for refusing to engage in activity that would be a violation of a FCA should report such retaliation to the University Compliance Officer. The appropriate Compliance Officer will be responsible for investigating reports of retaliation or will refer the report to the appropriate University office for timely investigation.

Investigation

Vanderbilt takes all complaints and tips of fraud and false claims very seriously and will promptly initiate an investigation while complying with all applicable state and federal laws.

DEFINITIONS

Whistleblower
 An employee of Vanderbilt who reports an activity that employee considers to be illegal or dishonest to one or more parties in this Policy. The Whistleblower is not responsible for investigating the activity or for determining fault or corrective measures; appropriate management officials are charged with these responsibilities.

Retaliation
 Retaliation occurs when an employer (through a manager, supervisor, or administrator) fires an employee or takes any other type of adverse action against an employee for engaging in protected activity.

CONSEQUENCES OF NON-COMPLIANCE

Violation of this policy may result in disciplinary action, up to and including termination of employment. 

PROCEDURES

These are the procedures for the False Claims Act and Whistleblower Protection Policy. Please review the following link for the False Claims Act and Whistleblower Protection Policy.

Reporting a Known or Suspected Violation of FFCA or TFCA

A.    An employee is expected to report any known or suspected violation of either the FFCA or the TFCA to the employee's supervisor, department head or chair, the University Compliance Officer, or to the 24-hour Confidential Help Line for the University at (866) 783-2287.

a.    In making reports to the Confidential Help Line, the caller may make a report anonymously. The compliance helplines have no call identification or number recognition capability.

B.    An employee may also report known or suspected violations of the FFCA to the OIG hotline, (800) 424-5197, by email at hotline@oig.doc.gov, or visit the website at https://www.oig.doc.gov. 

C.   All persons making reports of compliance concerns are assured that such reports will be considered confidential to the extent permitted by law. Such reports will be shared with others only on a bona fide need to know basis.

FREQUENTLY ASKED QUESTIONS

 

ADDITIONAL CONTACTS

Subject

Contact/Position

Office

Phone

Questions

Senior Director, Engagement Consulting, Employee and Labor Relations

People Experience

(615) 343-4788

RELATED POLICIES/DOCUMENTS

Equal Opportunity and Affirmative Action Policy

HISTORY

Issued:            

Reviewed:
Comment

Amended:
Comment

Disclaimer: The policies and procedures that guide employment practices are intended to assist in consistent administration and compliance.  Vanderbilt reserves the right to modify its policies and practices, in whole or in part, at any time.  Revisions to existing policies and procedures, and the development of new policies and procedures, will be made from time to time at the discretion of the University.   When new policies are implemented or existing policies are revised, the University will notify members of the University community as soon as practicable.  However, where differences occur, the most recent policy as reviewed and approved by the University will take precedence. Policies are not intended to apply to statements or actions protected under Section 7 of the National Labor Relations Act. (NLRA) The policies and procedures do not create a contract, implied or expressed, with at-will employees at Vanderbilt.