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McCollum Wants More Access to Medicaid Claims

July 6, 2010 - 6:00pm

The state attorney general is pushing the federal government to give his office improved access to Florida Medicaid claim files so it can detect fraud.

Attorney General Bill McCollum announced Wednesday that he and the state Agency for Health Care Administration (AHCA) have sent a formal waiver request to give the Attorney Generals Office authority to data-mine fee-for-service Medicaid claims files. The point is to detect fraud. This request to the secretary of the U.S. Department of Health and Human Services is the culmination of a 14-month campaign, during which McCollum has written to the federal government several times.

We believe together that its likely to be granted, hopefully within the very next few weeks, said McCollum, a Republican candidate for governor.

State fraud units are currently forbidden fromlaunching data-mining operations for the Medicaid programs fraud, a state-federal partnership expected to serve 2.7 million enrollees for a total of $18.7 billion this fiscal year.

The waivers would make the Attorney Generals Office the first agency in the nation not directly related to Medicaid to have access to Medicaid files. The AHCA administers Medicaid in the state,

The improved access to Medicaid files would allow McCollums Medicaid Fraud Control Unit, in what McCollum is referring to as a pilot project, to investigate specific incidents like inflated bills from practitioners offices.

Tom Arnold, the secretary of the AHCA, said the agency receives more than 1 million claims a day and has 100 staff members who investigate for fraud. The attorney generals staff would add to that investigative force.

We think the improvement by allowing the attorney generals Medicaid Fraud Control Unit in the office is a key to finding that fraud and abuse that has thus far eluded us,Arnold told reporters. Theres always a question of how much there is in terms of fraud and abuse, and the more eyes we can have looking at the claims history, the better it will be."

Reach Alex Tiegen at or 561-329-5389.

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