2014 Government Regulations & Business Summit
Join PBN and our sponsors for our Government Regulations & Business Summit on Th ...
By Richard Asinof
PROVIDENCE – Legislation that would require the state to use technology to screen Medicaid claims to prevent them from being paid to unlicensed, sanctioned or deceased providers passed the R.I. Senate on May 7.
The legislation, 2013-S 29A, was sponsored by Sen. Elizabeth A. Crowley (D-Central Falls) and has been sent to the House for approval.
“There is technology available to stop waste and fraud before Medicaid dollars are spent on it, and we should be using it,” Crowley said. “Every dollar we save is a dollar that can be used to help the many people who genuinely need assistance.”
The legislation seeks to stop suspicious claims before they are paid, since the current “pay and chase” model means that many who commit fraud frequently dissolve their businesses and change the names and addresses they use to make claims to stay ahead of investigators.
The legislation has the support of R.I. Executive Office of Health and Human Services Secretary Steven M. Costantino, whose agency is already soliciting proposals for such a system. The agency is also in the process of creating a new Program Integrity Unit to root out waste and fraud within Rhode Island’s health and human service programs, according to agency officials.