Efforts to crackdown on Medicaid fraud have led to positive results in New York and Missouri, where the states collected hundreds of millions of dollars in settlements and obtained a variety of criminal convictions.
New York, for instance, recouped more than $335 million last year from Medicaid fraud and abuse, the highest recovery in seven years, Attorney General Eric T. Scheiderman announced.
Schneiderman has bolstered the state's fraud unit by hiring additional investigators and prosecutors. "That initiative has paid off with record recoveries for taxpayers this year," he said last week in a statement.
The New York settlements included Cayuga Medical Center's $3.1 million payment to settle claims that it improperly billed for patients referred by physicians who had a financial relationship with the hospital.
Meanwhile, Missouri recovered more than $50 million in 2012, and more than $200 million over the past four years, Attorney General Chris Koster announced last week. The state collects nearly $25 for every dollar it spends in enforcement efforts.
Hospital leaders wishing to avoid legal issues with the Medicaid program should consider hiring seasoned compliance officers and ensure they can do their job unimpeded, according to HealthLeaders Media. They also should conduct regular audits and keep their board of directors fully informed to prevent improper activity.