Issaquah senator backs bill to tackle Medicaid fraud

May 21, 2011

By Warren Kagarise

NEW — 10 a.m. May 21, 2011

Cheryl Pflug

The state is a step closer to cracking down harder on Medicaid fraud, after lawmakers passed a measure to more aggressively prosecute fraud in the program and recover state funds.

State Sen. Cheryl Pflug, a registered nurse and a 5th Legislative District Republican, signed on as a cosponsor and, in a bipartisan effort, pushed the bill to colleagues. (The district includes Issaquah and East King County.)

Modeled on federal legislation, the state measure outlines incentives and whistleblower protections to employees who witness fraud in the workplace. The legislation allows the state to receive a greater share of recovered funds.

In addition, the measure empowers the state attorney general to contract out cases if the office is unable to pursue them.

“This legislation is crucial to successful recovery because it empowers the public to alert the state to known cases of fraud,” Pflug said in a statement. “The attorney general calls this bill an important tool in locating the source of fraud, and it will result in recovering hundreds of millions of dollars of state funds taken illegally.”

Unlike many states, Washington does not have a false claims act similar to federal law. The federal law allows individuals to sue providers who have defrauded the government. If the claim is substantiated, the person receives then a share of the recovery.

Medicaid is health insurance for qualifying low-income and needy people. Recipients include children, seniors and disabled people.

Experts estimate Medicaid fraud amounts to between 3 and 10 percent of expenditures.

Pflug joined another senator, Kent Democrat Karen Keiser to support the legislation. The measure passed the Senate in a 41-5 vote Thursday and headed to the House Ways & Means Committee for further consideration.

Issaquah’s other senators, Medina Democrat Rodney Tom and Mercer Island Republican Steve Litzow, supported the measure.

“By empowering individuals to shine a light on the hidden sources of Medicaid fraud, the state will be able to prosecute many more claims and recover millions more in settlements and penalties,” Keiser said in a statement.

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