Sen. Joe Negron, R-Palm City, and Attorney General Bill McCollum, a Republican gubernatorial candidate, advocated Tuesday for a plan that will allow the state to crack down on Medicaid fraud and also give it new potential to come down hard on HMO fraud.
Negrons bill, SB 8, will create an 11-member strike force to investigate Medicaid fraud. The bill, filed March 1, also expands the attorney generals Medicaid Fraud Control Unit to investigate Medicaid fraud in HMOs.
Theyre going to be a bright light shining on our Medicaid program, said Negron.
The Medicaid and Public Assistance Fraud Strike Force, estimated by Negron to cost $1.5 million, will develop plans for discovering and prosecuting Medicaid fraud and will find new ways to use technology and data sharing to analyze the crime. In addition, the strike force will distribute grants to local fraud investigation efforts.
The team will answer to the state's chief financial officer and attorney general. The strike force will include the secretary of Healthcare Administration, secretary of Children and Family Services, state surgeon general, two sheriffs, two chiefs of police and a state attorney.
Medicaid fraud has plagued the state for years. McCollum launched the Control Unit in 2007 to combat it. And yet, despite fewer cases last year, Florida is 39th in the nation when convicting fraud and 25th when recovering money. The state Agency for Health Care Administration, which audits healthcare pr
ograms, said in its annual report that its overpayment recoveries in the 2008-2009 fiscal year rose to $45 million from $29 million.
Chief Financial Officer Alex Sink, Democratic candidate for governor, has said McCollum didn't do enough to fight Medicaid fraud. McCollum responded today, saying he had investigated and convicted record cases of fraud. The Unit recovered $198 million last year alone, McCollum said.
The bill proposes that the state expand its HMO fraud investigations by collating them with the state Division of Insurance Fraud. The state spends more than $2.4 billion on HMOs, its second-largest Medicaid expenditure.
I think its been a low priority for whatever reason, said McCollum. But now, its going to be high-priority.
Tara Wall, vice president for Amerigroup Medicaid HMO, said she hadn't heard of Negrons bill.
What I can say is, we've teamed up with states and the federal government (to combat fraud) in the past, she said, and will continue to do so.
Amerigroup Florida, which has 236,000 clients in the state, puts a priority on finding and stopping waste, and the effort is important to the companys standings with clients.
It rings true to the people we serve and the states we partner with, she said.
