A Grand Jury Report finds details about Medicaid fraud


HARRISBURG Pa. (WTAJ) — “These programs are easily manipulated to facilitate fraud,” said Attorney General Josh Shapiro.

Matt Heckel says that, on Monday, Attorney General Josh Shapiro announced the findings of a Grand Jury Report Investigating the ‘Pennsylvania Medical Assistance’, or Medicaid program. It provides care to almost three million low-income residents across the state. 

“That’s about 21 percent of our state’s population,” said Shapiro.

The investigation stemmed from a pair of independent Medicaid fraud investigations. The grand jury found issues within the program because it allowed patients to be exploited for financial gain. 

“And it impacted the quality of the care provided in a negative way,” said Shapiro.

The Grand Jury made three recommendations. The first is legislation that mandates people looking to provide services paid for with Medicaid funds be required to register with the state to obtain a “state provider identifier.”

“Without this identifier, investigators have to go through the burdensome process of requesting documents from provider agencies, simply to identify who’s providing services in the first place,” said Shapiro.

Shapiro says that this takes away from their ability to investigate. Other recommendations include mandating that the date and time of services be provided in claims. And that the state’s department of human services establish standardized training for service providers.

“I’m confident that we can all work together, and work in a bipartisan manner within the legislature, to address the issues raised by the grand jury, and implement its recommendations,” said Shapiro.

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February 07 2021 06:30 pm

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