August 20, 2010
Media Contact: Jenn Meale
Phone: (850) 245-0150
Attorney General's Medicaid Fraud Control Unit Tops $400 Million in Recoveries Since 2007
TALLAHASSEE, FL – Attorney General Bill McCollum today announced that his Medicaid Fraud Control Unit has topped $400 million in recoveries, following a record-breaking year in 2009. The Attorney General’s Medicaid Fraud Control Unit investigates and prosecutes fraud involving physicians, pharmacists, hospitals, durable medical equipment suppliers and others suspected of intentionally defrauding the states Medicaid program.
“Medicaid fraud is a heartless crime that drains away resources intended for our citizens who need medical assistance,” said Attorney General McCollum. “Every single dollar we recover benefits not only those citizens, but also the Florida taxpayers who have funded the Medicaid program.”
Over the past three years, the Attorney General has looked for ways to increase the recoveries from Medicaid fraud. In 2007, the Attorney General created the Complex Civil Enforcement Bureau, which is a section within the Medicaid Fraud Control Unit. The Bureau investigates and litigates cases that allege violations of the Florida False Claims Act when the false claims were submitted to the Florida Medicaid Program. Of the Medicaid fraud recoveries, more than $37 million has gone to the state’s General Revenue fund.
In 2009, Attorney General McCollum also supported legislation that created a new program intended to financially reward informants who provide original information on Medicaid fraud violations that leads to the recovery of a fine, civil or criminal penalties, or forfeiture of property. The funding for the payments comes from a portion of recoveries made pursuant to the Florida False Claims Act when those recoveries pertain to false claims made to the Medicaid program.
The Attorney General also recently obtained approval to launch a pilot program unique to Florida that will make Florida a national leader in fighting Medicaid fraud. The pilot program has been a priority of Attorney General McCollum’s for over a year, and now for the first time the Medicaid Fraud Control Unit will be able to routinely analyzes Medicaid claims data to detect fraud. The Unit can now mine data on the billing practices of Medicaid providers such as hospitals doctors, and pharmacies. The access to this information will enable the Unit to identify and put a stop to more instances of Medicaid fraud, cracking down on fraud and those who commit it.
Prior to obtaining approval for the pilot program from the Department of Health and Human Services, state Medicaid Fraud Control Units were prohibited by federal code from proactively reviewing data to determine whether fraud is taking place. The Attorney General has been working directly with federal authorities for more than a year to enact this pilot program. Florida is the first and currently the only state to obtain a waiver of this type.