RD299 - 2012 Recommendations to Strengthen the Prevention, Detection, and Prosecution of Medicaid Fraud and Abuse

Executive Summary:
The 2012 Appropriation Act, Item 307 VVV, directed the Director of the Department of Medical Assistance Services, in consultation with the Secretary of Health and Human Resources and the Director of the Medicaid Fraud Control Unit within the Office of the Attorney General, to develop a report containing recommendations to strengthen the prevention, detection, and prosecution of Medicaid fraud and abuse committed by recipients and service providers. The report shall provide estimates of the cost of implementing any new strategies to reduce and prevent Medicaid fraud and abuse as well as the potential cost savings that might be achieved. Specific consideration shall be given to enhancing the Commonwealth's ability, within federal law, of excluding or removing providers that are determined to pose a threat to the health and safety of recipients and/or to the fiscal integrity of the program. Attached is the required report which was due by December 1, 2012.