Two Republican representatives want to crack down on Medicaid fraud.
Presenting HB5660 on behalf of Rep. Jim Durkin (R-Western Springs), chief co-sponsor Rep. David Olsen (R-Downers Grove) detailed how the bill increases criminal and civil penalties for any person, firm, corporation or association found guilty of medical assistance fraud.
“This bill’s intent is to further crackdown on those companies and other individuals that attempt to defraud Medicaid in our state,” Olsen said at Tuesday's House Human Services Committee hearing.
Rep. Rep. David Olsen (R-Downers Grove) presenting Medicaid fraud legislation April 10
In 2017, the Office of the Inspector General implemented enforcement initiatives amounting in $195.7 million in cost savings and avoidance, Olsen said, adding the legislation is a continued disincentive to control fraud.
Adding her support, Rep. Patricia Bellock (R-Hinsdale) said for all the years lawmakers have worked at preventing Medicaid fraud, the whole point of doing it "is so we can recoup the money to spend on all the most vulnerable populations."
"It always seems to be that people don’t understand that that is what we are trying to do," Bellock said. "It’s not money just for the state; its money to put back into the programs that we are trying to help."
Rep. Sheri Jesiel (R-Winthrop Harbor) said if “there is fraud there is fraud” and “wrong is wrong.”
“It’s not targeting anyone; it’s targeting wrong behavior,” Jesiel said. “And if it is low, then we should especially address the issue.”
Olsen said when one looks at Medicaid fraud, often the perception is that individuals are targets as the chief offenders of fraud.
That perception would be wrong.
“If you look at the dollar amount, the major perpetrators of fraud, in fact, happen to be major corporations or agencies,” Olsen said. “I think this bill is appropriately targeted to increased penalties across the board but especially those corporations and groups that really are really causing those large dollar losses to the state.”
Altering the criminal penalty from a Class A misdemeanor to a Class 4 felony and raising the criminal charge with each respective fraud is too much of a penalty, according to Rep. Litesa Wallace (D-Rockford), who said the penalties imposed are too severe.
“Wrong is wrong, but I am just wondering how this becomes a bill that saves us money,” Wallace said after running a scenario by Olsen regarding possible food stamp fraud.
Olsen said while he appreciated Wallace’s opinion, the real crux of the bill was to create disincentive through the criminal code.
“We are not instituting something that is new,” Olsen said, adding the fine amounts exist in statue as well as the criminal codes.
None of the entities has anything to fear if they are not committing fraud, added Rep. Norine Hammond (R-Macomb).
Though the vote for HB5660 was 5-2, five lawmakers did not vote so the bill will remain in committee.
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