A proposed rule released by the Centers for Medicare and Medicaid Services would expand the power of government officials to deny or revoke billing privileges for providers that pose a risk to federal healthcare programs.
Medicaid Fraud Control Units were notably inefficient in 2015, recovering just $744 million of an estimated $53.6 billion in improper payments. These numbers are particularly concerning given the increase in Medicaid enrollment, the projected spending within the program over the next six years and the fact that improper payment rates continue to push skyward. Is this a one-year anomaly, or is an unmanageable Medicaid budget outpacing our existing tools for controlling fraud?
According to new Medicaid Fraud Control Unit statistics and an interactive map released by the Office of Inspector General, the Texas MFCU netted more than $210 million in fraud recoveries in 2015, almost all of which came from criminal investigations.
President Barack Obama's fiscal year 2017 budget includes seven fraud, waste and abuse policies that would save $3.4 billion over the next decade, according to the White House.
Nearly three years after the New Mexico Human Services Department cut off Medicaid funding to 15 behavioral health providers, Attorney General Hector Balderas has cleared 10 companies of criminal fraud allegations, his office announced Monday.
Massachusetts state officials have referred a dozen home health agencies to the attorney general's Medicaid Fraud Division calling for an investigation of potentially fraudulent billing practices, according to The Boston Globe.
A Dallas woman has been sentenced to 57 months in prison after using the Medicaid provider numbers of four different licensed counselors to submit fraudulent psychotherapy services.
A managed care organization that specializes in long term care in New York City has agreed to pay $47 million for enrolling ineligible beneficiaries in the plan, according to the New York Attorney General's Office.
Florida lawmakers delayed a vote on a Medicaid reimbursement bill after Attorney General Pam Bondi argued the legislation would disrupt the state's case against two medical labs and could have broad implications for fraud litigation in other states, according to WCGU Public Media.
While juggling a number of other scandals, newly sworn-in Louisiana state Sen. Troy Brown is now answering questions about his long history of Medicaid fraud investigations that have led to more than $90,000 in fines, according to WWLTV.com.