McCollum Announces Funding for Medicaid Fraud Informant Reward Program
TALLAHASSEE - Attorney General Bill McCollum today announced that a new Medicaid fraud informant program, created by statute, will receive $1 million from a settlement announced yesterday with Pfizer, Inc. The program is intended to financially reward informants who provide original information on Medicaid fraud violations that leads to the recovery of a fine, civil or criminal penalties, or forfeiture of property.
"Encouraging people in the health care system to ferret out fraud and report back to authorities will be an excellent resource for our Medicaid Fraud Control Unit," said Attorney General McCollum. "Every dollar saved from Medicaid fraud is a dollar we can spend providing care to those who need it the most."
Tips can be reported by calling the Attorney General's Fraud Hotline at 1-866-966-7226 or 850-414-3990. The Medicaid Fraud Control Unit has a process to protect the identities of confidential informants. Tips will only be paid out after a case has been resolved.
The program was created as a provision of Senate Bill 1986, sponsored by Senator Don Gaetz during the 2009 Legislative Session. The funding for the payments comes from a portion of recoveries made pursuant to the Florida False Claims Act when those recoveries pertain to false claims made to the Medicaid program. The amount of the reward may be up to 25 percent of the amount recovered, or a maximum of $500,000 per case. The law also requires that all Medicaid recipients receive information annually on the reward program and how to report criminal Medicaid fraud.
In addition to creating and funding the informant program, the law also addresses systemic health care fraud and enacts tough anti-fraud measures in the Medicaid program. The provisions include a requirement that a list of all Medicaid providers sanctioned or terminated for cause is posted on the Agency for Health Care Administration's website and that Medicaid provider prescription and billing patterns are tracked and evaluated against medical necessity criteria and coverage limitation guidelines.
The Pfizer settlement, which will provide $1.08 million to the program, is the largest in history for the Florida Medicaid Control Unit and will ultimately send approximately $9.7 million to the State's General Revenue Fund.
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