House approves measure to combat Medicaid fraud

April 10, 2010|By Annie Linskey | annie.linskey@baltsun.com

Maryland's attorney general moved a step closer to collecting more civil damages in Medicaid fraud cases as the House of Delegates approved a measure Friday that cracks down on false medical claims.

"Finally we have given Maryland the opportunity to combat fraud," said Lt. Gov. Anthony G. Brown, who pushed for the legislation on behalf of the administration. "This is going to prove to be an important tool as we expand the pool" of people eligible for Medicaid.

The measure is identical to one that was passed by the Senate. Gov. Martin O'Malley still needs to sign it into law.

State officials estimate that 5 percent to 10 percent of the $6.2 billion spent annually on Medicaid is the result of false claims - including shady administrators billing the government extra for medications or doctors creating phantom patients.

The legislation encourages whistle-blowers to come forward by allowing anyone with knowledge of false Medicaid claims to file a lawsuit and share a percentage of damages.

The governor assumes in his 2010-2011 budget that the enhanced enforcement tool will net the state $20 million.

And Brown noted, fraud could become more widespread as additional patients are brought onto the Medicaid rolls with the newly approved federal expansion of health care.

A similar measure introduced last year failed amid stiff opposition from hospitals, which account for about a third of the state's Medicaid claims. They were concerned that the new rules would invite an onslaught of frivolous lawsuits.

This year, hospitals and small providers met early in the session and hammered out a compromise that requires the state to sign onto any civil suits for the litigation to move forward.

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