FOR IMMEDIATE RELEASE
State Rep. Tina Davis
Davis introduces health care fraud legislation
HARRISBURG, Feb. 15 – State Rep. Tina Davis, D-Bucks, recently introduced a package of legislation to address health care fraud.
"I've drafted a package of bills to address the issue of fraud in Pennsylvania's Medicaid program, as well as other state health care programs like the Children's Health Insurance Program and adultBasic," Davis said. "In 2009 alone, it is estimated that nearly $54 billion in losses to the Medicaid and Medicare programs was due to fraud. Further, it has been proven repeatedly that investments in fraud detection and enforcement pay for themselves many times over."
Davis said the pair of bills builds upon recently enacted state and federal laws by extending protection to Pennsylvania's state programs.
The first bill, H.B. 636, would amend the Crimes Code to define the crime of "health care program fraud." It would make that fraud a felony with monetary penalties and degree of felony dependent upon the value involved in the illegal activity.
House Bill 637 would make it the responsibility of Pennsylvania executive agencies to fight fraud in health care programs. This legislation would enhance the authority of the departments of Public Welfare and Insurance and other executive agencies managing health care programs to ferret out fraud and abuse of programs.
In addition, the legislation would set out the responsibilities for the Office of Attorney General in investigating and prosecuting Medicaid and other health care program fraud. Fraud warnings would be required to be provided to recipients, contractors, and third-party administrators. Further, agencies would be required to develop and implement comprehensive anti-fraud plans.