DHH launches new system to root out fraud and
abuse in Medicaid

Tuesday, July 5, 2011  |  Contact: Lisa R. Faust; (225) 342-7913 or (225) 252-3579 (cell)

BATON ROUGE - Beginning this week, the Louisiana Department of Health and Hospitals is phasing in increased time for review of claims for Medicaid services to help root out fraud and abuse in the system.

The goal of the program is to step up the Department's efforts to combat waste, fraud and abuse in the Medicaid system. It is estimated that nationally as much as 10 percent of Medicaid and Medicare expenses are diverted by wasteful, fraudulent and abusive activities.

"While we have been working hard in recent years to improve our systems for identifying fraud and abuse, we know that this additional measure will give our staff the time necessary to flag problem claims that could help us save millions in the long run," said DHH Secretary Bruce D. Greenstein.  "Stealing or misusing taxpayer money simply cannot be tolerated. That is why I have made targeting such fraud and abuse with a laser-like focus one of our department's top priorities."

Because of the additional review time, health care providers will be paid one day later than usual beginning this week with automated payments hitting bank accounts on Thursday instead of Wednesday. The same schedule will apply throughout the month of July. In subsequent months, the payments will continue to be pushed out further in a similar manner until there is a full additional 14-day window for claims reviews.

"We know this is going to be a transition for our health care community, so we are phasing in the additional time throughout the fiscal year to ensure they have time to adjust their businesses appropriately," DHH Undersecretary Jerry Phillips said.

If you suspect fraud or abuse in the Medicaid program, please report it to DHH's Fraud Hotline at 1-800-488-2917.

The Louisiana Department of Health and Hospitals strives to protect and promote health statewide and to ensure access to medical, preventive and rehabilitative services for all state citizens. To learn more about DHH, visit http://www.dhh.louisiana.gov. For up-to-date health information, news and emergency updates, follow DHH's blog, Twitter account and Facebook.