Bill Would Reward Medicaid Fraud Whistle-Blowers
Published: 2010-06-10 18:43:11
Author: WBALTV.com | March 10, 2010
ANNAPOLIS, Md. -- The governor's effort to curb medical fraud is meeting resistance in Annapolis from medical providers.
Medical fraud, waste and abuse costs Maryland taxpayers hundreds of millions of dollars each year.
The O'Malley administration is going after that money through legislation that would give those who blow the whistle on fraudulent acts a cut of the proceeds gained from civil action against the accused.
"Whistle-blowers are very important because people who commit fraud don't want to get caught. So, it is important to have individuals who have inside information on the operation into how the fraud is being developed and perpetrated," said state Health Secretary John Colmers.
State officials emphasized that these are not cases of billing errors or negligence. The type of fraud they're discussing involves purposely charging for services not rendered using a medical category to get higher reimbursements, charging for unnecessary treatment and billing for services on a non-existing patient.
Current Maryland law doesn't offer civil relief. Action can only be taken criminally, and the maximum penalty is the recovery of the money lost to fraud.
The legislation opens the door for the state and the whistle-blower to seek civil relief together or separately.
The federal government and 25 states, including Virginia, have similar statures.
"In Virginia, the average health care fraud case recovery was $7 million a year since the passage of the Medical Fraud Recovery Act. In the last three years, Virginia has recovered $228 million each year," said northern Virginia attorney Zachary Kitts.
Full story
Published: 2010-06-10 18:43:11
Author: WBALTV.com | March 10, 2010
ANNAPOLIS, Md. -- The governor's effort to curb medical fraud is meeting resistance in Annapolis from medical providers.
Medical fraud, waste and abuse costs Maryland taxpayers hundreds of millions of dollars each year.
The O'Malley administration is going after that money through legislation that would give those who blow the whistle on fraudulent acts a cut of the proceeds gained from civil action against the accused.
"Whistle-blowers are very important because people who commit fraud don't want to get caught. So, it is important to have individuals who have inside information on the operation into how the fraud is being developed and perpetrated," said state Health Secretary John Colmers.
State officials emphasized that these are not cases of billing errors or negligence. The type of fraud they're discussing involves purposely charging for services not rendered using a medical category to get higher reimbursements, charging for unnecessary treatment and billing for services on a non-existing patient.
Current Maryland law doesn't offer civil relief. Action can only be taken criminally, and the maximum penalty is the recovery of the money lost to fraud.
The legislation opens the door for the state and the whistle-blower to seek civil relief together or separately.
The federal government and 25 states, including Virginia, have similar statures.
"In Virginia, the average health care fraud case recovery was $7 million a year since the passage of the Medical Fraud Recovery Act. In the last three years, Virginia has recovered $228 million each year," said northern Virginia attorney Zachary Kitts.
Full story