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What is WYOMING DOING about medicaid Fraud?

Wyoming will not allow resources to be wasted or mis-spent, nor will it overlook those who take advantage of the system.  Every Wyoming taxpayer bears the cost of the crime of Medicaid fraud. Wyoming has to cover fraud losses by decreasing other government services and raising taxes. The state will continue to diligently track down instances of Medicaid fraud. Correcting overpayments and prosecuting offending providers and clients helps to keep costs as low as possible; ensures that tax dollars are being spent properly; and helps protect our most vulnerable citizens and provides them with the healthcare services they need and deserve.

The state of Wyoming does not tolerate Medicaid fraud and neither should you. Our goal is to make sure that all citizens of Wyoming know that we are serious about maintaining the integrity of Medicaid and the funds entrusted to us. We also want Wyoming citizens to know how to identify and report suspected fraud.

To that end, we have established a toll-free number (1-855-846-2563) dedicated to taking calls from citizens reporting suspected Medicaid fraud. Calls may be made to ask questions or share concerns about possible provider or client fraud and/or abuse. Concerns reported will be fully investigated by the Quality Assurance/Medicaid Program Integrity Staff. When a credible allegation is found, the Medicaid Fraud Control Unit (the office of the Attorney General that prosecutes Medicaid criminal activity) is alerted and the case is referred for further investigation and potential prosecution.

Wyoming will receive more than $1.7 million from this week’s record-setting fraud settlement against pharmaceutical giant GlaxoSmithKline, the state announced Tuesday.

The British company has agreed to pay $3 billion to resolve accusations it marketed drugs for off-label uses and failed to report safety data to federal regulators. The health care fraud settlement is the largest of its kind in the U.S., according to the Department of Justice. (more…)

The National Health Care Anti-Fraud Association (NHCAA) estimates conservatively that 3% of all health care spending is lost to health care fraud. Estimates by other government and law enforcement agencies place the loss due to health care fraud as high as 10%.[1]