S.B.
1
APPROPRIATIONS ACT
Senate Floor
Amendments
Amendment 9 February 28, 2000 3:11 PM
Senator Leonard M. Blackham
proposes the following amendments:
1. Page 7, Line 193: After line 193 insert:
"It is the intent of the Legislature that the Attorney General use
these funds to develop a comprehensive Medicaid fraud detection,
investigation, and prosecution program. Recent history
demonstrates that, to be effective, a comprehensive program must
include the following elements: a) credible processes for
identifying potential fraud situations; b) expert medical advice to
distinguish acceptable community practice from potentially
fraudulent medical practice; c) expert legal guidance to distinguish
between civil and criminal situations, with appropriate legal
remedies defined for each, and for the civil component it is the
Legislature's intent that the Attorney General enter into a
memorandum of agreement with the Department of Health to
perform these functions; d) strong due process guidelines to assure
medicaid providers of fair and respectful treatment; e) well
developed employee training programs to insure staff understand
their missions and conduct in performing that mission; and f) well
developed processes that distinguish between field audits, potential
fraud discovery, and criminal seizures of records. Further, the
Attorney General shall insure that this comprehensive Medicaid
Fraud Program is administered in a manner that allocates a
proportionate measure of fraud detection effort to urban Medicaid
providers. This will require the Attorney General to develop
methodologies and tools for assessing potential Medicaid fraud
under the managed care arrangements in use on the Wasatch Front.
Finally, it is the intent of the Legislature that the Attorney General
shall report to the 2001 Legislature regarding its success in
complying with this intent statement."