January 27, 2006
Jefferson City, Mo. — Attorney General Jay Nixon announced today that an investigation by his office revealed that prison inmates remained improperly on Medicaid rolls costing the Medicaid program more than $306,000.
Thirteen health care organizations were paid by the state Medicaid program to provide services to state prison inmates over a three-year period. Prison inmates are not eligible for Medicaid benefits according to state and federal statutes.
The Attorney General’s Medicaid Fraud Control Unit discovered the discrepancy while examining the records of the health care organizations from January 2003 through January 2006. The investigation revealed that Missouri’s Medicaid program was inappropriately billed and subsequently paid for service provided to incarcerated individuals who are ineligible for such benefits under state and federal law.
In all, 13 health care organizations were found to have been improperly paid for the services for a total of $306,000. Nixon is demanding that they immediately reimburse the Missouri Medicaid program for the outstanding amount owed the state.
"In an era when over 90,000 Missouri citizens have been cut off the Medicaid rolls, the notion that convicted felons could improperly receive benefits when they are ineligible to do so is obviously inappropriate," Nixon said. "Due to the diligent investigation by our Medicaid Fraud Control Unit, we are ensuring that money that was improperly paid out of the Medicaid program has been returned to Missouri taxpayers."
Nixon created the Medicaid Fraud Control Unit in 1994. Since its inception, the unit has been highly successful in uncovering and prosecuting provider fraud around the state. In 2005, Nixon’s office collected $27.9 million from providers who had defrauded the Medicaid program.