Proposal Would Tackle False Pennsylvania Medicaid Claims Without Encouraging Private Lawsuits

Pennsylvania state Representative Rob Kauffman (R-Chambersburg) is preparing a bill to strengthen enforcement against Medicaid fraud, suggesting other legislation aimed at the problem would spur unneeded litigation. 

Kauffman’s measure would exact triple damages when a court finds a care provider deliberately and improperly claimed funds from Medicaid, the federal-state healthcare program for low-income Americans. The bill would also empower the commonwealth’s inspector general to impose civil penalties on Medicaid scammers and dedicate new funds to the state attorney general’s Medicaid Fraud Control Unit. 

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Pennsylvania Cabinet Officer Says New Medicaid Fraud Prevention System Coming in June

Pennsylvania’s acting human services secretary on Tuesday told lawmakers an improved state system to detect Medicaid fraud will be in place this summer. 

The comments from anesthesiologist and former Montgomery County commissioner Val Arkoosh came as policymakers expressed concern about erroneous payments made by the government health-insurance program for the poor. In 2020, Governor Josh Shapiro (D) said in his previous capacity as state attorney general that his investigations indicated improper payments could total as much as $3 billion annually in Pennsylvania. That amounts to about one-tenth of all state Medicaid funds. 

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