North Carolina General Statutes
Article 2 - Programs of Public Assistance.
§ 108A-70.13 - False claims procedure.

108A-70.13. False claims procedure.
(a) The Attorney General shall have the authority to investigate, institute proceedings, compromise and settle any investigation or action, and perform all duties in connection with any civil action to enforce G.S. 108A-70.12.
(b) A civil action under G.S. 108A-70.12 may not be brought more than six years after the date the violation of G.S. 108A-70.12 is committed, or more than three years after the date when facts material to the right of action are known or reasonably should have been known by the official of the State of North Carolina charged with responsibility to act in the circumstances, but in no event more than 10 years after the date on which the violation is committed, whichever occurs last.
(c) In any action brought under G.S. 108A-70.12, the State shall be required to prove all essential elements of the cause of action, including damages, by the greater weight of the evidence.
(d) Notwithstanding any other provision of law or rule, a final judgment rendered in favor of the State in any criminal proceeding charging fraud or false statements, whether upon a verdict after trial or upon a plea of guilty or nolo contendere, shall estop the defendant from denying the essential elements of the offense in any action which involves the same transaction as in the criminal proceeding and which is brought under G.S. 108A-70.12.
(e) No criminal or administrative action need be brought against any provider as a condition for establishing civil liability under G.S. 108A-70.12. The civil liability under G.S. 108A-70.12 is in addition to any other criminal, civil, and administrative liabilities or penalties that may be prescribed by law. However, treble and double damages and civil penalties provided by G.S. 108A-70.12 shall not be assessed against a provider if treble or double damages or civil penalties have been previously assessed against the provider for the same claims under the federal False Claims Act, 31 U.S.C. 3729, et seq., or the federal Civil Monetary Penalty Law, 42 U.S.C. 1320a-7a. In the event that any provider is found liable under the provisions of this Act and is subsequently found liable for the same claim under the federal False Claims Act, or the appropriate sections of the federal Civil Monetary Penalty Law, the State and the Medical Assistance Program shall pay to the federal government on behalf of the provider any amounts, other than restitution, recovered or otherwise obtained by the State under this Act, not to exceed the amount of the federal damages and penalties.
(f) The amount of damages and number of violations of G.S. 108A-70.12 shall be established by the trial judge or, in the event of a jury trial, by jury verdict. The amount of penalties, treble or double damages, interest, cost of the investigation, and cost of the civil action shall be determined by the trial judge as prescribed in G.S. 108A-70.12(b).
(g) Venue for any action brought pursuant to G.S. 108A-70.12 shall be in either Wake County or in any county in which claim originated, or in which any statement or record was made, or acts done, or services, goods, or accommodations rendered in connection with any act constituting part of the violation of G.S. 108A-70.12. (1997-338, s. 1.)

Structure North Carolina General Statutes

North Carolina General Statutes

Chapter 108A - Social Services

Article 2 - Programs of Public Assistance.

§ 108A-24 - Definitions.

§ 108A-25 - Creation of programs; assumption by federally recognized tribe of programs.

§ 108A-25.1A - Responsibility for errors.

§ 108A-25.2 - Exemption from limitations for individuals convicted of certain drug-related felonies.

§ 108A-25.3 - Garnishment of wages to recoup fraudulent public assistance program payment.

§ 108A-25.4 - Use of payments under the Low-Income Energy Assistance Program and Crisis Intervention Program.

§ 108A-26 - Certain financial assistance and in-kind goods not considered in determining assistance paid under Chapters 108A and 111.

§ 108A-26.1 - Information sharing of outstanding arrest warrant of applicant for or recipient of program assistance.

§ 108A-26.2 - Fleeing felon or parole or probation violator; eligibility for program assistance; federal approval; review by department.

§ 108A-26.5 - NC FAST caseworker training and certification program.

§ 108A-27 - (See editor's note) Authorization and description of Work First Program; Work First Program changes; designation of Electing and Standard Program Counties.

§ 108A-27.01 - Income eligibility and payment level for Work First Family Assistance.

§ 108A-27.1 - Time limitations on assistance.

§ 108A-27.2 - General duties of the Department.

§ 108A-27.3 - Electing Counties - Duties of county boards of commissioners.

§ 108A-27.4 - Electing Counties - County Plan.

§ 108A-27.5 - Electing Counties - Duties of the Department.

§ 108A-27.6 - Standard Program Counties - Duties of county departments of social services and county boards of commissioners.

§ 108A-27.7 - Standard Program County Plan.

§ 108A-27.8 - Standard Program Counties - Duties of Department.

§ 108A-27.9 - State Plan.

§ 108A-27.10 - Duties of the Director of the Budget/Governor.

§ 108A-27.11 - Work First Program funding.

§ 108A-27.12 - Maintenance of effort.

§ 108A-27.13 - Performance standards.

§ 108A-27.14 - Corrective action.

§ 108A-27.15 - Assistance not an entitlement; appeals.

§ 108A-29 - Priority for employment services.

§ 108A-29.1 - Drug screening and testing for Work First Program applicants and recipients.

§ 108A-31 - Application for assistance.

§ 108A-36 - Assistance not assignable; checks payable to decedents.

§ 108A-37 - Personal representative for mismanaged public assistance.

§ 108A-38 - Protective and vendor payments.

§ 108A-39 - Fraudulent misrepresentation.

§ 108A-40 - (Effective until contingency met see note) Authorization of State-County Special Assistance Program.

§ 108A-41 - (Effective until contingency met see note) Eligibility.

§ 108A-42 - Determination of disability.

§ 108A-42.1 - (Effective once contingency met see note) State-County Special Assistance Program payment rates.

§ 108A-43 - Application procedure.

§ 108A-44 - State funds to counties.

§ 108A-45 - Participation.

§ 108A-46.1 - Transfer of assets for purposes of qualifying for State-county Special Assistance.

§ 108A-47 - Limitations on payments.

§ 108A-48 - State Foster Care Benefits Program.

§ 108A-49 - Foster care and adoption assistance payments.

§ 108A-49.1 - Foster care and adoption assistance payment rates.

§ 108A-50 - State benefits for certain adoptive children.

§ 108A-50.1 - Special Needs Adoptions Incentive Fund.

§ 108A-50.2 - Adoption Promotion Fund.

§ 108A-51 - Authorization for Food and Nutrition Services.

§ 108A-51.1 - Prohibition on certain waivers.

§ 108A-52 - Determination of eligibility.

§ 108A-53 - Fraudulent misrepresentation.

§ 108A-53.1 - Illegal possession or use of electronic food and nutrition benefits.

§ 108A-54 - (Effective until contingency met see note) Authorization of Medical Assistance Program; administration.

§ 108A-54.1 - Recodified as G.S108A-66.1 by Session Laws 2013-360, s12H.10(f), effective July 1, 2013.

§ 108A-54.1A - (Effective until contingency met see note) Amendments to Medicaid State Plan and Medicaid Waivers.

§ 108A-54.1B - Adoption of rules; State Plans, including amendments and waivers to State Plans, have effect of rules.

§ 108A-54.2 - (Effective until contingency met see note) Procedures for changing medical policy.

§ 108A-54.3A - Eligibility categories and income thresholds.

§ 108A-54.4 - Income disregard for federal cost-of-living adjustments.

§ 108A-54.5 - Maintenance of waivers for dependents of members of Armed Forces.

§ 108A-55 - Payments.

§ 108A-55.1 - Medicare enrollment required.

§ 108A-55.2 - Collaboration among agencies to ensure Medicaid-related services payments to eligible students with disabilities in public schools.

§ 108A-55.3 - Verification of State residency required for medical assistance.

§ 108A-55.4 - Insurers to provide certain information to Department of Health and Human Services.

§ 108A-55.5 - Eligibility monitoring for medical assistance.

§ 108A-56 - Acceptance of federal grants.

§ 108A-57 - (Effective until contingency met see note) Subrogation rights; withholding of information a misdemeanor.

§ 108A-57.1 - Rules governing transfer of medical assistance benefits between counties.

§ 108A-58.1 - Ineligibility for medical assistance based on transferring assets for less than fair market value.

§ 108A-58.2 - Waiver of transfer of assets penalty due to undue hardship.

§ 108A-59 - Acceptance of medical assistance constitutes assignment to the State of right to third party benefits; recovery procedure.

§ 108A-60 - Protection of patient property.

§ 108A-61.1 - Financial responsibility of a parent for a child under age 21 in a medical institution.

§ 108A-62 - Therapeutic leave for medical assistance patients.

§ 108A-63 - Medical assistance provider fraud.

§ 108A-63.1 - Health care fraud subpoena to produce documents.

§ 108A-64 - Medical assistance recipient fraud.

§ 108A-64.1 - Incentives to counties to recover fraudulent Medicaid expenditures.

§ 108A-65 - Conflict of interest.

§ 108A-66.1 - Medicaid buy-in for workers with disabilities.

§ 108A-67 - Medicare/Qualified Disabled Working Individuals.

§ 108A-68 - Drug Use Review Program; rules.

§ 108A-68.1 - Certain prescription drugs exempt from prior authorization requirements.

§ 108A-68.2 - (Effective until contingency met see note) Beneficiary lock-in program for certain controlled substances.

§ 108A-69 - Employer obligations.

§ 108A-70 - Recoupment of amounts spent on medical care.

§ 108A-70.4 - Long-Term Care Partnership Program.

§ 108A-70.5 - Medicaid Estate Recovery Plan.

§ 108A-70.9A - (Effective until contingency met see note) Definitions; Medicaid recipient appeals.

§ 108A-70.9B - (Effective until contingency met see note) Contested Medicaid cases.

§ 108A-70.9C - Informal review permitted.

§ 108A-70.10 - Short title.

§ 108A-70.11 - Definitions.

§ 108A-70.12 - Liability for certain acts; damages; effect of repayment.

§ 108A-70.13 - False claims procedure.

§ 108A-70.14 - Civil investigative demand.

§ 108A-70.15 - Employee remedies.

§ 108A-70.16 - Uniformity of interpretation.

§ 108A-70.30 - Recodified as Part 33 of Article 7 of Chapter 143B, G.S143B-344.46, by Session Laws 2013-360, s15.22(h), effective July 1, 2013.

§ 108A-70.36 - Applicability.

§ 108A-70.37 - Timely decision standards.

§ 108A-70.38 - Timely processing standards.

§ 108A-70.39 - Average processing time standards.

§ 108A-70.40 - Percentage processed timely standards.

§ 108A-70.41 - Corrective action.

§ 108A-70.42 - Temporary assumption of Medicaid eligibility administration.

§ 108A-70.43 - (Effective until contingency met see note) Reporting.

§ 108A-70.45 - Applicability.

§ 108A-70.46 - Audit of county Medicaid determinations.

§ 108A-70.47 - Medicaid eligibility determination processing accuracy standards.

§ 108A-70.48 - Quality assurance.

§ 108A-70.49 - Corrective action.

§ 108A-70.50 - Temporary assumption of Medicaid eligibility administration.

§ 108A-70.51 - (Effective until contingency met see note) Reporting.