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Senate passes bill to crack down on Medicaid fraud

By Chip Brownlee
Alabama Political Reporter

MONTGOMERY — The Alabama Senate passed a bill Tuesday intended to crack down on Medicaid fraud and reduce the burden on Alabama taxpayers.

The legislation, Senate Bill 85, sponsored by Sen. Trip Pittman was included on the Senate Republican Caucus’ priority list. It strengthens penalties against those who knowingly commit Medicaid fraud and providers who fraudulently bill the State for their services or tests.

“We have phenomenal health care providers and hospitals in our state, but there are some bad actors who have cost taxpayers millions of dollars through fraud,” Pittman said today. “This Medicaid fraud reduction bill will close the loopholes criminals used to bilk taxpayers.”

The bill amends Section 22-1-11 of the Code of Alabama to strengthen penalties by increasing the severity of Medicaid fraud from a simple felony to a Class C felony. It also extends penalties to corporations and other business entities.

In addition, the bill establishes a statute of limitations of six years that will allow prosecutors and the attorney general to prosecute the crime over a longer period of time.

The bill, Pittman hopes, will allow the Medicaid Agency to claw back on the Medicaid budget, which makes up the largest single portion of the State’s beleaguered General Fund.

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“Senator Pittman is one of the staunchest budget hawks in the Legislature, and I appreciate his focused efforts to protect our limited budget dollars against fraud,” Senate Majority Leader Greg Reed said.

The bill only strengthens penalties and establishes a statute of limitations, though. It doesn’t go as far to give more resources to the unit within the Attorney General’s Office that solely deals with Medicaid fraud, as some have called for.

In the 2016 fiscal year, the Attorney General’s Medicaid Fraud Control Unit opened 52 Medicaid fraud cases and recovered $16,921,362 in fees and fines.

A strengthened False Claim Act, if passed by the Senate, could impose liability on persons and companies commit fraud. If could also include statutes establishing qui tam, a term for rewarding a whistleblower who exposes fraud on the government for which they receive a 10 percent share of the recovery.

Currently, 35 states have a False Claims Act with qui tam. Alabama is not one of them.

During the 2016 Legislative Session, a bill was put forward to give the Attorney General’s Office more resources for its Medicaid fraud division. The bill died before serious consideration.


Email Chip at cbrownlee@alreporter.com or follow him on Twitter.

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Chip Brownlee is a former political reporter, online content manager and webmaster at the Alabama Political Reporter. He is now a reporter at The Trace, a non-profit newsroom covering guns in America.

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