Md. gets $200,000 to probe fraud in health care industry

October 06, 1995|By JOHN R. FRECE | JOHN R. FRECE,SUN STAFF

Maryland has been awarded a $200,000 U.S. Justice Department grant to set up a unit to investigate fraud in the health care industry, Attorney General J. Joseph Curran Jr. announced yesterday.

The Justice Department wants Maryland "to develop a prototype statewide health care fraud prosecution unit capable of investigating and prosecuting all types of health care fraud" that other states can copy, Mr. Curran said.

The effort will be aimed at those who commit fraud against private health care insurers, such as Blue Cross and Blue Shield, and the federal Medicare system. Maryland already has a unit that investigates fraud involving the federal-state Medicaid program.

Using that unit's expertise in tracking health care fraud cases, Mr. Curran said the state plans "to go after those people who try and rip off private insurers."

The new unit should begin considering cases within 30 days and be fully operational by the first of the year, said Michael Enright, a spokesman for Mr. Curran.

The General Accounting Office estimates that fraud and other abuses by health care providers amount to 10 percent to 15 percent of all health care expenditures. In Maryland, that translates into losses for insurers and the public of $300 million to $450 million annually, Mr. Curran said.

Fifteen states applied for the grant, and Maryland was one of three to receive a share of $600,000 in available funds. The

Justice Department has not identified the other two states, Mr. Enright said.

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