South Carolina Attorney General Alan Wilson is leading a nationwide coalition of states to petition the federal government for expanded authority to prosecute Medicaid fraud. Wilson, the GOP gubernatorial nominee, authored a letter to congressional leaders urging them to pass the proposed STOP Fraud in Medicaid Act.

Medicaid Fraud Prevention

The proposed legislation would enable states to investigate and prosecute beneficiary and recipient fraud, in addition to provider fraud. Currently, federal restrictions confine state Medicaid fraud units to investigating and prosecuting provider fraud.

Wilson stated that Medicaid is a shared state and federal responsibility, and when fraud goes unchecked, it drains resources meant for those truly in need and undermines public confidence in the program. The proposed legislation provides a common-sense solution to enhance the ability to fully protect the public treasury and ensure that every dollar spent in the Medicaid program is used appropriately.

According to the latest data from the U.S. Centers for Medicare and Medicaid Services (CMS), the current estimated improper payment rate for Medicaid is 6.12% (or $37.39 billion), up from 5.09% ($31.1 billion) the previous year. However, a report by the Paragon Health Institute suggests that the true amount of improper payments in Medicaid may be twice as high as reported.

Original reporting: FITSNews — read the source article.