Has Florida’s Medicaid Control Unit Committed Fraud?
Posted on Sunday, 17 of August , 2008 at 2:37 pm
COMMENTARY
By Dr. Sandra Frank
The thought of an agency assigned to protect our elderly and disabled committing fraud is unthinkable yet in 2003, Florida Attorney General Charlie Crist, who at the time was overseeing the Medicaid Fraud Control Unit, received a letter from the U.S. Department of Health and Human Services (HHS) on Jan. 29, 2003.
The letter states the Medicaid Fraud Control Unit (MFCU) was cited for not providing complete and accurate case information, employing individuals who did not meet established minimum qualifications and seven other deficiencies. The state of Florida was placed on “high risk” of losing millions of dollars of federal funding from Medicaid and the MFCU had been placed on probation for a year. This information can be found in the State of Florida Attorney General’s yearly audit report.
Attorney General Crist had to act quickly and he only had one year to clean up this mess. What would it take to show HHS that Attorney General Crist was taking aggressive actions to correct the problems with the MFCU?
Should the MFCU go out and arrest all those they think maybe are committing Medicaid Fraud? Is that what happened? Look at the statistics from August 2007.
The statistics show the arrests made by the MFCU from July 2005 through February 2007.
1,270 cases. Were closed by MFCU. (That sounds great)
88 (7 percent) cases. Resulted in convictions or settlements. (Good job, so far)
1,182 (93 percent) cases. Lacked evidence or were unfounded. (what’s wrong with this?)
Is this considered significant?
What about the 1,182 cases and the people who were wrongfully accused? Did they become a part of the arrest statistics? Were the 1,270 arrests the reason the U.S. Department of Health and Human Services lifted the probation? They would not be aware for at least one to two years that only 88 cases resulted in convictions and 1,182 cases were unfounded.
I remember when Crist was running for Governor; he stated he helped clean up Medicaid fraud. Did Gov. Crist create a witch hunt that would destroy thousands of lives of honest hard working people, just to arrest a few?
In the August 2007 Annual Audit most of the MFCU deficiencies had been corrected, except the MFCU was still not providing complete and accurate case information or as stated, “did not always include documentation”. Because the MFCU has been cited four years by the U.S. Department of Health and Human Services for not verifying information or not always providing documentation, would this be considered a pattern of misconduct as defined by Title 42, U.S.C.?
Sometimes I wonder if I should consider myself a martyr or a victim whose life was insignificant. The only problem is I do not want my life to be insignificant. I have worked all my life helping others, in the hope of leaving my son a legacy of integrity, compassion and commitment.
http://www.myflorida.com/audgen/pages/pdf_files/2006-028.pdf; page 11
http://www.myflorida.com/audgen/pages/pdf_files/2008-012.pdf 8-17-08
Category: Consumers, Disabled, Elder Care, Florida, Government, Health, Insurance, Opinion
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