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Tue Apr 16, 2019, 11:27 AM

Seeking to reduce fraud, new grand jury report calls for fixes to Pennsylvania's Medicaid program

Mandated training and other fixes would expand the tool chest of options available to state officials and law enforcement officers as they seek to prevent and combat fraud in Pennsylvania’s Medicaid program, a grand jury report released Monday has revealed.

“We all want to ensure that people get the highest quality care possible,” Pennsylvania Attorney General Josh Shapiro, whose office oversaw the grand jury, said during a news conference at his Harrisburg office.

The grand jury’s recommendations, which stemmed from Medicaid fraud prosecutions by Shapiro’s office, call for three changes:

* Requiring service providers who do not have what’s known as a “national provider identifier” to obtain a state identification number, as is the case in Ohio. They would also be required to include that number on every claim for payment, making them easier to track.
* Requiring providers to go through mandated, standardized training on their job duties and how to properly bill for their services.
* Requiring all state Medicaid forms to include both the date, as well as start and end times when a service is provided. Right now, that level of specificity is not required.

Read more: https://www.penncapital-star.com/criminal-justice/seeking-to-reduce-fraud-new-grand-jury-report-calls-for-fixes-to-pa-s-medicaid-program/

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