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Published: 2010-03-24 04:01:00
Updated: 2010-03-24 15:46:37

Perdue begins Medicaid fraud, waste prevention effort


Gov. Bev Perdue
Gov. Bev Perdue
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Gov. Beverly Perdue says it's time for North Carolina to enter the technological age when it comes to curbing fraud and abuse of the state's $10 billion Medicaid program.

Perdue announced on Wednesday the state's Medicaid office has started using a computer program designed to review Medicaid files to determine whether patients or physicians are gaming the system. The effort requires scanning untold pages of paper documents over the years.

A new "Medicaid SWAT team" of special investigators will review cases flagged by the computer software as suspicious.

“In these tough times, when Medicaid enrollment is growing even as we face deep budget shortfalls, we must do more to root out waste and crack down on folks who are abusing or defrauding Medicaid,” Perdue said in a statement. “Tens of millions of taxpayer dollars each year are wasted on Medicaid fraud, waste and abuse. It’s got to stop, and we will not allow it to continue.”

Health and Human Services Secretary Lanier Cansler said the effort won't require a large state investment since program provider IBM will get paid based on 10 percent of the money from the waste and fraud that is uncovered.

Perdue also called for toughening North Carolina’s anti-fraud laws by stopping kickbacks to providers who refer patients for Medicaid services and ending the practice of soliciting patients for services they don’t need. She also wants to double the staff of the Medicaid Investigations Unit in the Attorney General's Office and create an awareness campaign to encourage people and providers to report Medicaid fraud, waste and abuse when they suspect it.

The Medicaid Investigations Unit is composed of investigators, auditors, attorneys and State Bureau of Investigation agents who look into cases of fraud, abuse and neglect of residents in medical facilities that receive Medicaid funding. Last year, the unit recovered $52 million. Proceeds from civil settlements typically reimburse Medicaid, and penalties go to North Carolina public schools.

“Medicaid fraud hurts our state’s most vulnerable residents and robs taxpayers,” Attorney General Roy Cooper said in a statement. “Adding more investigators and ways to detect fraud is the right direction to go to stop those who abuse the system.”


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She is only targeting medical care for fraud, while she and Easley have ignored for years the fraud that takes place in CAP/MR/DD services. The bill through agencies, case managers, and huge army of people who are supposed to assure the integrity of these payments commit huge dollars in medicaid fraud. When it's reported, rereported, documented, resent, resurrected for years on end, the end result is that the governor and her employees decline to correct it or punish it. In other words, the enable it to keep those federal dollars coming here.

give a drug test before you give anyone a medicade card or welfare check half would not get a check. you have to take a drug test for a lot of jobs

This is the FRAUD and waste that should be investigated...it doesn't take a genius to figure out who Bev Perdue works for...and its not the Taxpayers of NC!

http://www.news-record.com/content/2008/10/31/article/perdue_mccrory_campaigning_hard_in_final_days

http://www.capitol-monitor.org/non-profit-profiles/seancseiu-packs-political-powe.php

http://www.campaignfreedom.org/blog/id.766/blog_detail.asp

http://projects.newsobserver.com/tags/seiu?page=1

http://www.seanc.org/search/?query=board%20members

http://www.seanc.org/about/board.aspx

jgriffith3792 it's not new technology, however Bev is caught. Roy Cooper, the partisan who apparently cares more about party than Constitutional principle, isn't going to join the other states and sue so Bev has to look like she's doing something to address the concerns of those of us who despise this latest government power grab.

Of course it won't, and it doesn't, but it does two things. Bev looks like she's doing something (trolling for votes never ends you know) , and yet another person in this state (friend of the party in power) will get their pockets lined with taxpayer money when this 'program' is established to do nothing...

And who says NC is corrupt?!?

Either they're so detached they have no clue how the system really works or this really is just to buy some time and save face. I feel sorry for the poor schmucks that have to scan thousands and thousands of pages of information -that's already electronically recorded to begin with-. If they wanted real results they'd have HP run reports already and would have the SBI knocking on doors.

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