Jim Rosica
Gov. Rick Scott gave Attorney General Pam Bondi a heads up on Monday that some of the 129 hospitals being audited for Medicaid fraud or waste could be referred to her office for criminal prosecution.
Scott is on the warpath against hospitals that participate in the statewide Medicaid Managed Care program, concerned that some are over-billing the system.
Medicaid, a joint federal-state program, eats up about a third of the annual state budget.
What’s more: The state will lose about $1 billion because the federal government said it will stop paying into the Low Income Pool, a state-federal pot of money given to many hospitals to help pay for their charity care.
In a letter released to media, Scott said Agency for Health Care Administration Secretary Liz Dudek last month asked all Florida hospitals and insurance plans in the Medicaid Managed Care program to certify what they were charging.
“Unfortunately, some hospitals either completely failed to reply, replied past the deadline, or submitted information that raised additional questions and requires further review to ensure compliance with Florida law,” Scott wrote to Bondi.
Scott said he then told Dudek to start auditing hospitals. He said he plans to make sure they are “compliant with state law and (that) there are no instances of fraud or abuse.”
As a result, 129 hospitals across the state are in the process of being audited, his letter shows, from Pensacola to Miami.
“Hospitals have made a record $3.75 billion in profits according to the most recent available data,” Scott wrote.
He told Bondi that Dudek will forward the names of any facilities “where we find suspicion of fraud or abuse to your office for investigation and potential prosecution.”
“I know that protecting consumers and combating fraudulent activity are top priorities for your office and we welcome (your) assistance … to hold all entities accountable for following the law,” he said.
