Actions for Medicaid fraud called for by Legislature

House Bill 4417 has been introduced in the 2018 Legislature calling for a host of measures to be undertaken by the State to prevent fraud and abuse of the Medicaid by providers and beneficiaries.

The proposal includes dis-enrolling health care providers who commit fraud and requiring them to repay Medicaid for the sums of monies they defrauded the agency.  The bill also imposes financial penalties against providers for failure to keep medical records for a specific time period.

Providers shall also be penalized if they submit a false claim.   When submitting a claim for payment, the provider is to certify that it has complied with all material conditions for payment.   Submitting a false claim constitute fraud and the agreement for provision of services shall terminate, according to the proposed law.

Civil action is to be brought against a provider within five years from the time the Medicaid Fraud Control Unit is made aware of the existence of the false, fraudulent or fictitious claim.

In addition to actions against providers for fraudulent acts, individuals covered under public assistance can also be penalized for fraud including abuse of Supplemental Nutrition Assistance Program or SNAP.