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2012 Session

Budget Amendments - HB30 (Committee Approved)

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Plan for Medicaid Administrative Hearings to Combat Recipient Fraud (language only)

Item 310 #2h

Item 310 #2h

Health And Human Resources
Medical Assistance Services, Department of

Language
Page 240, after line 53, insert:
"I.  The Department of Medical  Assistance Services shall develop a plan to implement an Administrative Disqualification Hearing process to increase the Commonwealth's ability to disqualify individuals from Medicaid who have committed fraud but who would otherwise not be prosecuted.  The plan shall include an assessment of the potential financial resources needed to implement the process and a determination regarding whether the process is permitted by federal and state laws and regulations, and whether changes to state laws or regulations are necessary to implement the process.  The department shall report on the plan to the House Appropriations and Senate Finance Committees by November 1, 2012."


Explanation
(This amendment adds language requiring the Department of Medical Assistance Services to develop a plan to implement an Administrative Disqualification Hearing process to increase the state's ability to disqualify individuals from Medicaid who have committed fraud but who would otherwise not be prosecuted. A recent study by the Joint Legislative Audit and Review Commission indicated that the Medicaid program could benefit from the implementation of an Administrative Disqualification Hearing process to reduce recipient fraud, similar to that used with a number of benefit programs administered by the Department of Social Services such as, the Supplemental Nutrition Assistance Program, the Temporary Assistance to Needy Families program and the child care subsidy program.)