Attorney General Pam Bondi was in Hialeah and Fort Lauderdale on Wednesday co-hosting media events on the national mortgage settlement, but she also had Medicaid on her mind.
Her office’s Medicaid fraud control unit is in the midst of a big hiring push. It’s looking to fill dozens of openings for analysts, auditors and accountants to dig through reams of data looking for suspicious bills that signal fraud. The bills are for services that were never provided, unnecessary procedures and unneeded medical equipment.
In August, responding to the number of Medicaid fraud cases in the state’s southern region, the attorney general’s office expanded the operational headquarters of its Medicaid unit to South Florida.
James Mann, deputy director of the unit, was transferred to oversee South Florida operations, and two other staff members were given new duties related to operations in the region, according to John Lucas, a spokesman for Bondi. The fraud unit staffs offices in Miami-Dade and Broward counties, as well as six others around the state.
“The majority of the fraud seems to be coming out of South Florida. The attorney general has asked us to put an emphasis on criminal prosecution in that area,” Mann was quoted as saying at the time.
Florida’s Medicaid program is the fourth-largest in the nation with more than 3.3 million recipients. Medicaid accounts for about 28 percent, or $20 billion, of the state budget, according to the Home Care Association of Florida.
On Jan. 3, Bondi and Liz Dudek, who heads the Florida Agency for Health Care Administration, released the state’s annual Medicaid fraud and abuse report covering activities of the agency and the attorney general’s fraud unit. The report concluded:
Total collections were almost $49.7 million, including $44.2 million in overpayments and investigative costs, fines, sanctions and interest. The unit also collected $74.2 million in federal Medicaid overpayments, and the agency’s third-party liability unit recovered $148.1 million.
The agency terminated the prescribing rights of 437 non-Medicaid providers who were prescribing pill mill-type drugs in suspicious amounts.
For every $1 spent to prevent fraud and abuse or to recover Medicaid funds obtained through fraud or abuse, the state gained $6.80.