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Lawmakers want the state Agency for Health Care Administration to explain why so much money is lost.
By JULIE HAUSERMAN, Times Staff Writer
© St. Petersburg Times, published January 3, 2002
TALLAHASSEE -- In the past five years, news about Medicaid fraud has poured out relentlessly.
A children's charity home bills the government for medical care for poor kids -- but the patients don't exist. Florida sends out more than $3-million to 6,000 poor people -- who already are dead. Miami dentists hire van drivers to round up poor children for dental care -- then inflate the bill and collect from taxpayers.
Some Florida lawmakers say the state agency that runs the Medicaid program hasn't done enough to stop fraud.
On Wednesday, the Florida Senate set up a new select subcommittee that will target Medicaid abuse. In particular, the Senate wants officials from the FloridaAgency for Health Care Administration to explain why the government is losing so much money to fraud.
How much money? A government audit in September estimated that the Agency for Health Care Administration may have lost between $445-million and $890-million on Medicaid fraud alone. This at a time when the state budget is short by more than $1-billion.
"We have serious budget problems, and we need to do everything we can to recoup those monies which are, in effect, stolen," said state Sen. Burt Saunders, a Naples Republican who has served in the Legislature since 1994. "I don't believe that AHCA is doing everything they can to recoup those dollars, and I'm going to find out why that is."
Saunders appointed himself and four senators to the committee: two Democrats and two Republicans. They include Ginny Brown-Waite, a Brooksville Republican. A select committee is convened for a limited time for a special purpose.
Brown-Waite said Wednesday that the committee is eager to get answers.
"My interpretation is that all gloves are off and we are going to be looking into this," Brown-Waite said.
It isn't unusual for state lawmakers to put agencies on the hot seat, but the Senate's announcement of the new committee was particularly harsh. It said the Agency for Health Care Administration"has failed to do all that it should to enforce Florida's Medicaid antifraud laws."
Wednesday, agency officials responded: "I don't think there's any reason to believe the agency has failed to do what we should have," said Judy Hefren, the agency's deputy inspector general.
The subcommittee plans to hold two hearings later this month, Saunders said. Its work will be completed within 30 days.
This isn't the first time officials have wrung their hands about Medicaid fraud, which provides health care for poor people, and Medicare, which provides health care to the elderly.
A statewide grand jury was convened in 1996 to investigate Medicaid fraud. In subsequent years, auditors from several different branches of government have revealed missing millions.
And, less than two years ago, the fraud hit the statehouse. Miami Republican Sen. Alberto Gutman, who once chaired the Senate's Health Care Committee, was sentenced to five years in prison for Medicare fraud.
In July, Gov. Jeb Bush named Rhonda M. Medows, a Jacksonville physician and insurance executive, to head the Agency for Health Care Administration. Medows replaced Ruben King-Shaw, who became deputy administrator of the Health Care Financing Administration in Washington.
-- Times researcher Deirdre Morrow contributed to this report.