MEDI-CAL: Anti-Fraud Legislation Would Oust Guilty Parties from Program
In an effort to crack down on Medi-Cal fraud that officials say costs the state $1 billion annually, Assemblywoman Gloria Romero (D-Monterey) has introduced legislation that would kick past abusers out of the program and require providers to post a $25,000 bond as collateral against overpayments. "This is enough money to provide health care for every uninsured child in the state of California," said Romero. The Los Angeles Times reports that AB 784, which will come before the Assembly Health Committee Tuesday, would "give auditors greater legal authority to access records that validate" Medi-Cal payments and would require the state "to license activities of people who receive per-patient referral fees for those they send to Medi-Cal providers." Romero said, "Existing regulations do not provide state agencies with sufficient tools to uncover or prevent fraudulent billings. To put an end to this abuse, we must have the enforcement powers to investigate and to prosecute suspicious cases." State Controller Kathleen Connell agreed that the state lacks the necessary authority to crack down on fraudulent Medi-Cal operators. Her office, along with the state and U.S. attorney general's, has established a task force to fight Medi-Cal abuse (Ha, 4/2).
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