HARRISBURG – Legislation introduced by Rep. Clint Owlett (R-Tioga/Bradford/Potter) to help prevent improper payments in the state’s Medicaid program was approved Tuesday by the House State Government Committee.
The measure is part of a six-bill package designed to prevent waste, fraud and abuse in the state’s Medicaid system.
“While government has a responsibility to provide a safety net for people in need, it also has a responsibility to taxpayers who foot the bill for that safety net,” Owlett said.
“We need to be proactive in stopping bad actors who are trying to game the system. Not only are they misusing taxpayer dollars but also taking resources away from the people who truly need them.”
House Bill 2354 is designed to identify, detect and prevent improper payments before they happen by establishing a searchable database that would help identify organizations, individuals and entities that are not eligible to receive funds from a Commonwealth agency. The bill is modeled after the federal Do Not Pay law.
“According to a November report by the federal Centers for Medicare and Medicaid Services, Pennsylvania made more than $2 billion in improper payments to the Children’s Health Insurance Program and Medicaid. If left uncorrected, these improper payments would require a $930 million repayment to the federal government,” Owlett said.
“The last thing we need at a time when so many people are struggling and needing assistance is to spend money on improper payments and then pay out even more to the federal government because of it.
“Every dollar we have available for public assistance should go to the people who are truly in need,” he added.
Owlett noted the state of Oregon saved $286 for every $1 it spent after enacting the Do Not Pay law. In addition to the savings that come from preventing the improper payments themselves, the bill would also save the Commonwealth the costs associated with trying to recover those payments.
Owlett’s bill is one of six introduced earlier this year in response to a grand jury report on fraud in Pennsylvania’s Medical Assistance Program, also known as Medicaid, released by Attorney General Josh Shapiro’s office and a report recently released by the House Government Oversight Committee.
Other bills in the package include:
- House Bill 2350, which would require any provider which seeks to operate in the Medicaid program use either a National Provider Identification number or register for a State Provider Identification number.
- House Bill 2351, which would increase penalties for making a false claim against the Medicaid program.
- House Bill 2352, which would create a state version of the federal False Claims Act to recoup additional funds from false claims made against Medicaid.
- House Bill 2353, which would require state agencies to assess their program expenditures to determine how susceptible they are to improper payment.
- House Bill 2355, which would require any Medicaid Managed Care Organization to enter into an agreement with the Department of Human Services to allow the department to recoup any Medicaid funds which were spent on a provider preventable condition.
The measures were approved by the House State Government Committee (House Bills 2353 and 2354) and the House Human Services Committee (House Bills 2350, 2351, 2352 and 2355). All of the bills now go to the full House for consideration.
