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ID H0439
Bill
Status
2/3/2014
Primary Sponsor
Health and Welfare Committee
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AI Summary
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Department of Health and Welfare shall adopt technological tools to investigate, audit, and control fraud, waste, and abuse in Medicaid and other public assistance programs administered by the department.
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Department must implement fraud detection activities including analytics, data modeling, statistical profiling, use of Medicaid Management Information Systems (MMIS) data, National Correct Coding Initiative (NCCI), and Recovery Audit Contractors (RAC) to identify overpayments.
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Department shall establish an incentive program providing rewards to citizens who report criminal fraud by public assistance recipients, with rewards paid upon criminal conviction and amounts set as a percentage of recovery.
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Department shall utilize available federal funding under the Patient Protection and Affordable Care Act and Social Security Act sections 1903(a)(3) and 1903(r) to implement fraud prevention provisions.
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Department shall report annually to germane legislative committees on fraud prevention efforts for all public assistance programs administered by the department.
Legislative Description
Adds to existing law to provide that the Department of Health and Welfare shall use technological tools to investigate, audit and control fraud in Medicaid and public assistance programs, to provide for activities to reduce fraud, waste and abuse, to authorize the department to utilize federal funding when available and to provide for annual reporting by the department.
PUBLIC ASSISTANCE
Last Action
Reported Printed and Referred to Health & Welfare
2/4/2014