05-22-2015 | Health Law Blog

Medicaid Fraud in the News

By: BrownWinick

A couple of recent pieces in The Des Moines Register caught our eye.  On May 10, 2015, the Register ran an article and an editorial discussing Medicaid fraud and abuse generally, and specifically referencing a matter in which the Department of Human Services (“DHS”) curiously did not pursue the owner of a Des Moines counseling agency for the repayment of almost $2 million of overbillings.  Both the article and the editorial questioned why the State DHS did not seek a civil court judgment, criminal charges, or even a partial repayment for the overbillings, despite the fact that the State of Iowa was required to repay the federal government the almost $1.2 million for losses incurred by the overbillings from the counseling agency.

The Register pieces indicate what may be heightened scrutiny by the press on Medicaid fraud and the enforcement practices of the DHS.  Of particular interest, the article notes that Medicaid cost U.S. taxpayers $488 billion last year and estimated that as much as $100 billion of that amount is lost annually to waste, fraud and abuse.  The article also noted that in Iowa last year the Medicaid program spent $4.1 billion and the State recovered $24.4 million through criminal and civil proceedings against companies accused of overbilling.