How are states trying to prevent Medicaid fraud?

On Behalf of | Aug 25, 2020 | Fraud |

Preventing a problem could prove less challenging than dealing with a recurring one. Officials in many states realize that preventing Medicaid fraud can save money and resources. Those who commit acts of Medicaid fraud in New York may not realize how severe the penalties are while others might be desperate enough to take risks. In addition to prosecuting people for fraud, several states wish to fight Medicaid fraud on many fronts.

According to reports, federal and state governments lose billions to Medicaid fraud each year. It is not surprising that many officials make recovering fraudulently received funds a priority. Recovering all fraudulently paid funds seems unrealistic, and there are costs associated with getting the money back. As such, preventive steps appear attractive to local and federal authorities.

Establishing ways to detect patterns indicative of fraud may help. For example, California employs an annual study to discover waste or fraud. Sometimes, administrative errors contribute to mistakes as opposed to fraud. Regardless, the state still loses money over the issue.

Florida employs an approach involving unannounced in-person visits. One fiscal year saw more than $90 million in recoveries and cost avoidances. While visiting offices unannounced may seem cumbersome, but the process does deliver results.

New Jersey maintains another approach to addressing possible fraud. In the Garden State, officials may look at a person’s background for prior fraudulent behavior. If circumstances warrant further action, officials may attempt to prevent the person from receiving Medicaid payments.

The penalties for Medicaid fraud could be severe. New Jersey law reveals that people guilty of Medicaid fraud may receive up to three years in prison and a $10,000 fine. Regardless of the state, a person might face prosecution under federal charges. If an individual has been accused of Medicaid fraud, they may want to speak with a criminal defense attorney about potential outcomes in their case.

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