insurance fraud Archives - American Press

Auditor notes fraud fund deficiencies

Medicaid fraud is an ongoing problem for the state, and the Medical Assistance Programs Fraud Fund needs to be fully funded to assure taxpayers aren’t being ripped off.Louisiana Legislative Auditor Daryl G. Purpera noted in a recent report deficiencies in the fund for both the Louisiana Department of Health and the Office of the Attorney General due to lack of procedures to identify monies that should be deposited into the fund.“As a result,” auditors said, “LDH did not deposit $2.8 million and the AG did not deposit $712,713 into the fund (more commonly known as the Medicaid Fraud Fund) in accordance with state law. Specifically, LDH did not deposit $2,797,768 in fines and penalties assessed between fiscal years 2012 and 2017 into the fund until February 2018.”Also in fiscal year 2016, the AG deposited $712,713 less than the amount indicated by its own memos. In addition, the AG could not provide memos to support $23,782 in deposits made into the fund between fiscal years 2013 and 2O15.LDH also incorrectly deposited $323,570 into the fund in fiscal year 2012 that should have been placed into the Nursing Home Residents’ Trust Fund. LDH staff told auditors that deposits into the Medicaid Fraud Fund made before fiscal year 2012 may also have been improper because the memos for these monies did not clearly specify where they were to be deposited.Purpera noted the purpose of the Medicaid Fraud Fund is to pay the state share of the operations of the AG’s Medicaid Fraud Control Unit, which is responsible for investigating and prosecuting Medicaid provider fraud.The AG spent nearly $7.1 million between fiscal years 2012 and 2017 from the fund for the MFCU, in accordance with state law, according to Pupera.Medicaid is a growing expense for Louisiana taxpayers and all fraud and abuse needs to be eradicated. The funds that make Medicaid fraud prosecutions possible, need to be fully funded.Audit finds deficiencies