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Serpa Medicaid Fraud Bill Works to Cut Back Waste

If passed, the bill would allow for a faster solution to cutting back millions in waste in a stagnant economy.

 

STATE HOUSE – While the federal government has taken unprecedented steps toward health care reform in this country, Rep. Patricia A. Serpa (D-Dist. 27, West Warwick, Coventry,Warwick) says Medicaid fraud is still a topic that should stay a part of the conversation this year.

The bill (2013-H 5734) would allow the state to use technology to identify fraudulent activity in the Medicaid and Children’s Health Insurance Program (CHIP) before payment is made. Last year, the House of Representatives passed a resolution respectfully requesting Gov. Lincoln D. Chafee to implement programs and methodology to improve Medicaid integrity inRhode Island, building a foundation for the introduction of the current legislation.

“If someone described this bill as an attempt to fine-tune the health care system, it would be an understatement when you look at how many millions of dollars in taxpayer money is at stake,” Representative Serpa said. “I recognize that the governor is already beginning to make moves in order to go after people who abuse the system, and I am extremely grateful for this. But I want to just reiterate my desire to dedicate some of these funds we would be saving to filling in the deficit. The more revenue we can direct back to the general fund and the deficit, the more money we can spare for other important aspects of the budget like economic development initiatives and education. This legislation would have a full, immediate effect – time is money, and in this case, it’s taxpayer money. Our cities and towns can use all the help we can give right now, and we need a system in place so that this is not a one-time fix.”

The representative made a parallel to the EBT card fraud recently uncovered in a WPRI news investigation, adding that it is the government’s responsibility to crack down on fraud after it has been identified.

“Senator (David) Bates, of Barrington, introduced legislation banning the purchase of alcohol, lottery tickets and tobacco with EBT cards this year,” Representative Serpa said. “None of those purchases fall in line with the intended purpose of those cards. And just like those people trying to get around the state’s welfare system, there are people trying to get around the Medicaid system. The exception is that the EBT card waste may amount to thousands of dollars, and Medicaid and CHIP fraud could amount to millions.”

The federal government has estimated that state Medicaid programs pay around $18 billion total annually attributed to fraud, waste and abuse of the system. In order to work toward eliminating waste in Rhode Island, Representative Serpa’s bill calls for modern pre-payment prevention and recovery solutions.

Cosponsors of the legislation include Representatives Deborah A. Fellela (D-Dist. 43, Johnston) and Lisa Baldelli Hunt (D-Dist. 49, Woonsocket).

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