Medicaid Fraud

State senators voted overwhelmingly Tuesday for legislation intended to combat Medicaid fraud, a year after rejecting a similar measure amid strong opposition from the state's hospitals. The bill approved Tuesday included a compromise with the hospitals that lawmakers said would protect them against frivolous lawsuits. It passed 37 to 8. "It is a great day," said Lt. Gov. Anthony G. Brown, who has been lobbying for the bill on behalf of the O'Malley administration. The legislation encourages whistle-blowers to bring fraud lawsuits, and allows them to share in damages awarded.

State health regulators disclosed Thursday that they have fined Baltimore Behavioral Health Inc. $90,000 for employing a psychiatrist who had been convicted several years earlier of Medicaid fraud. The fine equals the salary and benefits that the nonprofit clinic paid Dr. Roman Ostrovsky during the 14 months he worked there as an administrator. State officials said BBH should never have hired him because he was on a federal no-hire list because of his fraud conviction. The penalty comes amid questions about the finances at the West Pratt Street mental health clinic, which was the subject of a recent Baltimore Sun investigation.

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.

Baltimore Behavioral Health Inc. is under investigation by the state's health inspector general for employing a psychiatrist who had been convicted several years earlier of Medicaid fraud. The doctor, Roman Ostrovsky, 53, is one of eight physicians employed by the nonprofit mental health clinic over the past decade who have been disciplined by the Maryland Board of Physicians, with sanctions ranging from reprimand to license revocation, public records show. One doctor became intoxicated while on call at BBH, board records show, and another groped a 22-year-old patient in an exam room.

The Maryland General Assembly is poised to get tough on fraud that officials say is sapping hundreds of millions of dollars from the state's health care program for the poor, a crackdown that comes as Maryland braces for an increase in Medicaid patients through the just-passed national health insurance overhaul. State health and budget officials estimate that between 5 percent and 10 percent of Maryland's $6 billion in Medicaid spending is fraudulent, with companies seeking payment for wheelchairs never delivered and doctors filing claims for patients who never received treatment.

State senators voted overwhelmingly Tuesday for legislation intended to combat Medicaid fraud, a year after rejecting a similar measure amid strong opposition from the state's hospitals. The bill approved Tuesday included a compromise with the hospitals that lawmakers said would protect them against frivolous lawsuits. It passed, 37-8. "It is a great day," said Lt. Gov. Anthony G. Brown, who has been lobbying for the bill on behalf of the O'Malley administration. The legislation encourages whistle-blowers to bring fraud lawsuits, and allows them to share in damages awarded.

Baltimore Behavioral Health Inc. is under investigation by the state's health inspector general for employing a psychiatrist who had been convicted several years earlier of Medicaid fraud. The doctor, Roman Ostrovsky, 53, is one of eight physicians employed by the nonprofit mental health clinic over the past decade who have been disciplined by the Maryland Board of Physicians, with sanctions ranging from reprimand to license revocation, public records show. One doctor became intoxicated while on call at BBH, board records show, and another groped a 22-year-old patient in an exam room.

A Baltimore County grand jury charged a Towson obstetrician yesterday with 125 counts of Medicaid fraud as well as obstruction of justice, theft and altering medical records, including an allegation that he billed for dozens of diaphragm fittings he hadn't performed.Dr. Carter J. Williams, 42, practices at the Greater Baltimore Medical Center and has an office at the Physicians Pavilion there, said prosecutor Gale Rasin Caplan, director of the Medicaid fraud unit of the state attorney general's office.

A Columbia pharmacist pleaded guilty yesterday to defrauding the state's Medicaid program by billing for prescriptions that were never filled, the attorney general's office said.Jim Su Pak, 35, who owns the Hickory Plaza Pharmacy on Hickory Ridge Road, was sentenced in District Court in Baltimore to a year of probation before judgment and was ordered to pay a $500 fine. He also was ordered to repay $361.76 to the Medicaid program, the money that was paid to him from the fraudulent billings.

The billing clerk of a Montgomery County day-care center has pleaded guilty to Medicaid fraud in a scheme prosecutors say was so blatant that administrators at the center joked about going to prison together.The clerk, Jane Margolius of Silver Spring, entered the guilty plea to Medicaid fraud yesterday in Baltimore Circuit Court. Margolius has agreed to cooperate with the attorney general's office, which is investigating fraud at her former employer, the Oak Leaf Center in Bethesda.Much of the $1.6 million the center billed the state Medicaid program for juvenile psychiatric services between 1986 and May 1990 may have been improper, said Carolyn J. McElroy, an assistant attorney general prosecuting the case.

As discouraging as government finances — both in Annapolis and Washington — have been of late, there is some good news on the horizon. Estimates released last week by the Maryland Department of Health and Mental Hygiene suggest the state will collect about $20 million more from scofflaws attempting to defraud the Medicaid program. That may not solve the state's projected $1 billion-plus projected budget deficit in fiscal 2012, but it certainly doesn't hurt. In the fiscal year that ended June 30, the health department recovered about $26.5 million as a result of Medicaid fraud, waste and abuse investigations, which was also higher than in previous years.

Here's our take on 10 good things that happened during the 90-day General Assembly session, which concluded on Monday, and 10 bad things. Good: •Sex offender laws. Thanks in no small part to the appeal Monday by Jennifer Foxwell, the mother of kidnap and murder victim Sarah Foxwell, the General Assembly passed a package of sex offender reforms that will increase penalties and make Maryland's sex offender registry more effective. We'll never know if these laws could have saved Sarah, but they should help make Maryland's children safer.

The General Assembly considered hundreds of bills during its 90-day session, and adopted only a fraction. Here's a sample of what got accomplished, and what didn't: Baby bottles Lawamkers approved a ban on the chemical bisphenol-A from use in baby bottles and infan' cups passed its final hurdle in the General Assembly on Thursday. The prohibition would taking effect in 2012, making Maryland the fourth state to ban the chemical linked to developmental problems in young children, reproductive troubles in women and other diseases.

Gov. Martin O'Malley gave the state more power to prosecute Medicaid fraud and established a patient-centered medical care program, among the 170 bills he signed into law Tuesday morning. "Today is a great day for health care," said Lt. Gov. Anthony G. Brown, who lobbied for the bills on behalf of the governor. The Democratic administration said the measures will help the state reduce medical costs and improve care. The crackdown on Medicaid fraud comes after three years of unsuccessful attempts to pass the legislation, Brown said.

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.

Maryland is on the verge of enacting a state false claims act allowing whistleblowers and the state to target those entities ripping off state health programs. Maryland would be the 26th state to enact such a false claims act. Overall, false claims acts are an unqualified success in helping to detect fraud and recover money falsely claimed against government programs. False claims acts on the national and state levels have recovered more than $20 billion since 1986. Opponents have argued that Maryland doesn't need a law and that the federal false claims act would suffice.

State senators voted overwhelmingly Tuesday for legislation intended to combat Medicaid fraud, a year after rejecting a similar measure amid strong opposition from the state's hospitals. The bill approved Tuesday included a compromise with the hospitals that lawmakers said would protect them against frivolous lawsuits. It passed, 37-8. "It is a great day," said Lt. Gov. Anthony G. Brown, who has been lobbying for the bill on behalf of the O'Malley administration. The legislation encourages whistle-blowers to bring fraud lawsuits, and allows them to share in damages awarded.

The Maryland General Assembly is poised to get tough on fraud that officials say is sapping hundreds of millions of dollars from the state's health care program for the poor, a crackdown that comes as Maryland braces for an increase in Medicaid patients through the just-passed national health insurance overhaul. State health and budget officials estimate that between 5 percent and 10 percent of Maryland's $6 billion in Medicaid spending is fraudulent, with companies seeking payment for wheelchairs never delivered and doctors filing claims for patients who never received treatment.