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Florida has been one of the leading hotspots of Medicaid fraud for years now. Last year, Bizjournals reported new charges filed in a $1 billion Medicare fraud and money laundering scheme and in January , a home health agency owner was convicted in a $57 million scheme. According to a report from the U.S. Department of Health & Human Services' Office of the Inspector General, the Federal Medicaid Fraud Control Units recovered more than $165.5 million from investigations and cases in Florida alone. The Importance of Healthcare Medicaid and Medicare Programs According to AHCA, the Medicaid program is funded by both state and federal tax dollars to assist or help low-income earners and helpless Floridians with their health care needs. When people or providers get benefits they don’t deserve, it wastes your tax dollars and takes away assistance from those who really needs them. Medicaid Fraud What is Medicaid fraud and how can a person or a provider commit such act? Medicaid fraud happens when a person or provider intentionally collects unauthorize benefits from the government resulting to monetary kickbacks which are supposedly for low-income earners. The government has been battling these fraudsters for years. They’ve been filing cases and doing investigations which resulted to millions of dollar on recoveries but still the numbers keeps on coming. Just this year, the Centers for Medicare & Medicaid Services (CMS) has suspended enrollment to Medicare for another 6 months to stop Medicare fraud. The moratorium affects states such as Florida, Texas, Illinois, and Michigan. The federal agency wrote in the rule: The circumstances warranting the imposition of the moratoria have not yet abated, and CMS has determined that the moratoria are still needed as we monitor the indicators and continue with administrative actions to combat fraud and abuse, such as payment suspensions and revocations of provider/supplier numbers. How do you prevent Medicaid Fraud? In order to prevent fraud or protect yourself from fraud: - Do not ask for medical services you don’t need from your doctor or service provider.
- Be careful with anyone offering you free screening or test in exchange for your Medicaid card number.
- Be careful with anyone offering you services or treatments that you feel you do not need.
- Do not give your Medicaid card number to anyone except your doctor, hospital or other service provider.
If you suspect anyone committing fraud, don’t hesitate to report them to authorities. Furthermore, in order to protect yourself or your business from penalty or listed on the exclusion list, the federal state recommends regular exclusions checks be performed on all employees and providers using all state databases. This will ensure that no one from your business were listed in the exclusion list which may cost you thousands of dollars when caught.
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Florida Medicaid Fraud, Medicaid Fraud, healthcare fraud, Federal Medicaid Fraud Control Units,
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