- The Washington Times - Wednesday, October 2, 2002

RICHMOND (AP) Attorney General Jerry W. Kilgore yesterday said the state recovered a record $12 million in fraudulent Medicaid payments in the last fiscal year.
The figure easily tops the previous best of $2.5 million, but it likely is just a fraction of the amount the state and federal governments lose to Medicaid cheats, the director of the attorney general's Medicaid Fraud Control Unit said at a news conference.
Randall L. Clouse said the federal government has estimated that fraud accounts for as much as 10 percent of state Medicaid budgets. That would be $300 million a year in Virginia, which has a Medicaid budget of $3 billion.
"So we've got work ahead of us," Mr. Kilgore said. "We had a banner year, but we know there's more to do out there."
Mr. Clouse said most of the fraud occurs when health care providers deliberately charge too much for a service like billing a 10-mile ambulance run at a 50-mile rate or collect for a service that was not provided.
Mr. Kilgore said Medicaid fraud is a "persistent problem" that diminishes the quality of treatment and drives up the cost of health care for everyone. In the fiscal year that ended June 30, he said, 18 persons were convicted of cheating Medicaid in Virginia.
The criminal convictions resulted in more than $9.5 million in fines, asset forfeitures and court-ordered restitution. The fraud unit also recovered more than $2.5 million in civil actions. Mr. Kilgore said that after the federal government takes its share, Virginia gets $8 million.

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