Jun. 24, 2020

HARRISBURG – Working to prevent waste and fraud in the state’s Medicaid program, the state House today approved Rep. Clint Owlett’s (R-Tioga/Bradford/Potter) bill that would prevent improper payments.

“While we must always work to protect taxpayer dollars and prevent waste and fraud, it is more important now than ever,” Owlett said. “As a result of the COVID-19 shutdown across the state this spring, our economy has slowed substantially and revenue collections are far below what we anticipated when enacting the current year’s budget. We need to save every dollar we can to help balance the next fiscal year’s budget while also retaining the safety net programs for people who are truly in need.”

House Bill 2354 is designed to identify, detect and prevent improper payments before they happen by establishing a searchable database that would help identify organizations, individuals and entities that are not eligible to receive funds from a Commonwealth agency. The bill is modeled after the federal Do Not Pay law.

A November report by the federal Centers for Medicare and Medicaid Services indicated Pennsylvania made more than $2 billion in improper payments to the Children’s Health Insurance Program and Medicaid. If left uncorrected, these improper payments would require a $930 million repayment to the federal government.

“The last thing we need at a time when so many people are in need of assistance is to spend money on improper payments and then pay out even more to the federal government because of it,” Owlett said. “Every dollar we have available for public assistance should go to the people who are truly in need.”

Owlett noted the state of Oregon saved $286 for every $1 it spent after enacting the Do Not Pay law. In addition to the savings that come from preventing the improper payments themselves, the bill would also save the Commonwealth the costs associated with trying to recover those payments.

Owlett’s bill is one of six introduced earlier this year in response to a grand jury report on fraud in Pennsylvania’s Medical Assistance Program, also known as Medicaid, released by Attorney General Josh Shapiro’s office and a report recently released by the House Government Oversight Committee.

Other bills in the package include:

House Bill 2350, which would require any provider which seeks to operate in the Medicaid program use either a National Provider Identification number or register for a State Provider Identification number.
House Bill 2351, which would increase penalties for making a false claim against the Medicaid program.
House Bill 2352, which would create a state version of the federal False Claims Act to recoup additional funds from false claims made against Medicaid.
House Bill 2353, which would require state agencies to assess their program expenditures to determine how susceptible they are to improper payment.
House Bill 2355, which would require any Medicaid Managed Care Organization to enter into an agreement with the Department of Human Services to allow the department to recoup any Medicaid funds which were spent on a provider preventable condition.

With the exception of House Bills 2350 and 2352, the remaining measures in the bill package are now pending Senate consideration.

Representative Clint Owlett
68th District
Pennsylvania House of Representatives

Media Contact: Patricia Hippler