Florida House Passes Measure To Curb Medicaid, Medicare Fraud
The Florida House on Monday unanimously passed legislation that would increase licensing restrictions for certain health care service providers as a way to deter fraud in the Medicaid and Medicare programs, the Miami Herald reports.
Under the bill, proposed by state Rep. David Rivera (R), people would have to live in the U.S. for at least five years before they could obtain a license to operate home health care agencies, medical equipment providers or health clinics unless they file a bond of no less than $500,000. The bill would designate Miami-Dade County as a "health care fraud area of special concern." The measure also would require that people applying for operators' licenses submit proof that they have the financial ability to operate or start such a company. A one-year ban would be placed on new licenses in counties with higher numbers of home health care agencies. State regulators and industry groups say the rules would help prevent health care fraud in the region. State Sen. Carey Baker (R) has proposed a similar bill in the Florida Senate.
Miami-Dade County has 20% of the state's Medicaid beneficiaries, who account for 90%, or more than $55 million, of statewide home health care spending, according to the Florida Agency for Health Care Administration. A Herald investigation showed that Cuban immigrants often come to South Florida and work for fraudulent health care firms, then return to Cuba if they are investigated or prosecuted for these offenses. AHCA Inspector General Pete Williams said the "whole system is in jeopardy" if fraudulent claims continue to be processed. He noted that beneficiaries often receive kickbacks from fraudulent companies that use their Medicaid identification numbers for these claims (Weaver/Gilpatrick, Miami Herald, 4/28).