Also proposed is the creation of a Web site comparing prices of prescription drugs.
JEFFERSON CITY — The goal of cracking down on Medicaid fraud has found bipartisan support, a rarity in the yearlong debate on how to restructure the state program that provides health-care coverage for those with lower incomes.
The Senate’s General Laws Committee on Tuesday approved a bipartisan bill that would toughen penalties against health-care providers that submit Medicaid bills that cheat the state.
“People who have stolen Medicaid money from those who need it are creating victims in Missouri,” said Sen. Chuck Graham, D-Columbia.
Bills sponsored by Graham and Sens. Chris Koster, R-Harrisonville, and John Loudon, R-Ballwin, will be fused in an attempt to root out waste, fraud and abuse within Missouri’s Medicaid system.
Compensating people who blow the whistle on Medicaid fraud is a major point of contention in the bills. There are currently no financial incentives promised to whistle-blowers.
Koster’s bill would require a person convicted of Medicaid fraud to serve at least 85 percent of his or her sentence before being eligible for parole. Koster said the “85 percent rule” is usually reserved for violent crimes, such as murder, sexual assault and kidnapping.
“This is a statement of how seriously the government and legislature of Missouri takes this offense,” said Koster, a former prosecutor.
If the 85 percent rule is attached to Medicaid fraud, it would be the first time it would be applied to white-collar crime in Missouri, Koster said.
Senate President Pro Tem Mike Gibbons, R-Kirkwood, was apprehensive about applying such a harsh rule to this particular form of white-collar crime and not to others.
“I’m not sure I’m ready to apply a violent crime standard to (Medicaid fraud),” he said.
Graham, however, said a significant punishment is necessary because white-collar criminals are increasingly repeat offenders.
“I know people are going from company to company, re-offending over and over. Something must be done,” Graham said.
The combined legislation would allow people to sue providers who commit Medicaid fraud. It would also include numerous revisions to current law relating to the reporting and investigation of system fraud.
One major addition to current law would be a lifetime ban for any supplier convicted of Medicaid fraud beyond a reasonable doubt.
“This legislation would dramatically change policy of the state,” said Sen. Jason Crowell, R-Cape Giradeau, the committee’s chairman.
Anywhere from $200 million to $500 million is lost every year to Medicaid fraud in Missouri, Koster said.
The committee also decided to roll together two bills — SB 1091 and SB 1239 — that would create a Missouri prescription drug Web site to provide pricing information on the 50 most commonly used prescription medicines in Missouri.
The Web site, in conjunction with the Missouri Department of Social Services, would provide pharmacies’ retail prices for standard 30-day supplies of brand name and generic prescription drugs.
The Medicaid fraud and Web site bills will be sent to the Senate floor for debate.