Legislation sponsored by Rep. Wendi Thomas (R-Bucks) to fight fraud within Pennsylvania’s Medical Assistance Program, also called Medicaid, has unanimously passed the House.
“Medicaid fraud hurts both Pennsylvania taxpayers and those who depend on the Medicaid program,” Thomas said. “To reform and protect the system, we must encourage whistleblowers to speak out, put tools in place to better guard the system, and make the penalties for fraud so harsh there will be no incentive to commit the crime.”
Under House Bill 2351, the penalty for knowing or causing a fraudulent claim to be submitted would be a second-degree felony if the fraudulent claim is $100,000 or more. If the claim is between $2,000 and $100,000, the penalty for the fraudulent claim would be a third-degree felony. If the claim is $2,000 or less the penalty would be a third-degree misdemeanor.
According to the inspector general for the U.S. Department of Health and Human Services, the Commonwealth experienced $694 million in improper Medicaid payments. In March, Attorney General Josh Shapiro released a grand jury’s findings on ways to prevent Medicaid fraud.
According to a PennCapital-Star report Shapiro said his Medicaid Fraud unit made 292 arrests resulting in 173 convictions and recovered $34 million for the state in 2017.
“We can only stop Medicaid fraud when penalties are strong,” Thomas said. “If you plot to steal thousands from the Medicaid system, you should pay a harsh price.”
The measure now moves to the state senate for consideration