Senate debates legislation that would allow prosecution in Medicaid fraud cases

Jan 21, 2013

Wyoming Senate discusses Medicaid fraud.
Credit Bob Beck / Wyoming Public Radio

Wyoming is one of eight states that does not have the ability to pursue false claims in Medicaid cases.  A bill being debated in the state Senate would change that. 

Senator Ray Peterson says conservative estimates suggest that Wyoming is likely losing 15 million dollars a year to overbilling in Medicaid cases.  His bill would allow the state to investigate and prosecute Medicaid fraud.

“And the attitude is that it is really not hurting anybody… we got the money,” Peterson says. “But it is, because there are names and faces on coming short on Medicaid funds.  When the money runs out, the waiting list is there, benefits are reduced or eliminated completely.”

But Senators Chris Rothfuss and Floyd Esquibel expressed concern that doctors who make a bookkeeping error could face a felony conviction. 

Senator Charles Scott says the fraud issue is serious in Wyoming and must be addressed. 

“You think of how complex hospital bills are and I think a vigorous look at that and you are going to recover some real money,” Scott says.

Some Senators expressed concern that the bill might go too far in making criminals out of medical providers who simply make bookkeeping errors.  The issue will be debated two more times.