Senate Bill sb1632
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Florida Senate - 2002 SB 1632
By Senator Saunders
25-1126-02
1 A bill to be entitled
2 An act relating to Medicaid fraud; amending s.
3 409.920, F.S.; clarifying duties of the
4 Attorney General with respect to the statewide
5 program to control Medicaid fraud; authorizing
6 the Attorney General to seek civil remedies
7 under the Florida False Claims Act and other
8 laws; authorizing the Attorney General to refer
9 certain cases of overpayment and suspected
10 abusive activities to the Agency for Health
11 Care Administration; providing an effective
12 date.
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14 Be It Enacted by the Legislature of the State of Florida:
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16 Section 1. Subsections (7) and (8) of section 409.920,
17 Florida Statutes, are amended to read:
18 409.920 Medicaid provider fraud.--
19 (7) The Attorney General shall conduct a statewide
20 program of Medicaid fraud control. To accomplish this purpose,
21 the Attorney General shall:
22 (a) Investigate the possible criminal violation of any
23 applicable state law pertaining to fraud in the administration
24 of the Medicaid program, in the provision of medical
25 assistance, or in the activities of providers of health care
26 under the Medicaid program.
27 (b) Investigate the alleged abuse or neglect of
28 patients in health care facilities receiving payments under
29 the Medicaid program, in coordination with the agency.
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Florida Senate - 2002 SB 1632
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1 (c) Investigate the alleged misappropriation of
2 patients' private funds in health care facilities receiving
3 payments under the Medicaid program.
4 (d) Refer to the Office of Statewide Prosecution or
5 the appropriate state attorney all violations indicating a
6 substantial potential for criminal prosecution.
7 (e) Refer to the agency all suspected abusive
8 activities not of a criminal nature.
9 (f) Refer to the agency for collection each instance
10 of overpayment to a provider of health care under the Medicaid
11 program which is discovered during the course of an
12 investigation.
13 (e)(g) Safeguard the privacy rights of all individuals
14 and provide safeguards to prevent the use of patient medical
15 records for any reason beyond the scope of a specific
16 investigation for fraud or abuse, or both, without the
17 patient's written consent.
18 (8) In carrying out the duties and responsibilities
19 under this section subsection, the Attorney General may:
20 (a) Enter upon the premises of any health care
21 provider, excluding a physician, participating in the Medicaid
22 program to examine all accounts and records that may, in any
23 manner, be relevant in determining the existence of fraud in
24 the Medicaid program, to investigate alleged abuse or neglect
25 of patients, or to investigate alleged misappropriation of
26 patients' private funds. A participating physician is required
27 to make available any accounts or records that may, in any
28 manner, be relevant in determining the existence of fraud in
29 the Medicaid program. The accounts or records of a
30 non-Medicaid patient may not be reviewed by, or turned over
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Florida Senate - 2002 SB 1632
25-1126-02
1 to, the Attorney General without the patient's written
2 consent.
3 (b) Subpoena witnesses or materials, including medical
4 records relating to Medicaid recipients, within or outside the
5 state and, through any duly designated employee, administer
6 oaths and affirmations and collect evidence for possible use
7 in either civil or criminal judicial proceedings.
8 (c) Request and receive the assistance of any state
9 attorney or law enforcement agency in the investigation and
10 prosecution of any violation of this section.
11 (d) Seek any civil remedy provided by law, including,
12 but not limited to, the remedies provided under ss.
13 68.081-68.092, s. 812.035, and this chapter.
14 (e) Refer to the agency for collection any case of
15 overpayment to a provider of health care under the Medicaid
16 program which is discovered during the course of an
17 investigation.
18 (f) Refer to the agency any case of suspected abusive
19 activities that are not of a criminal nature.
20 Section 2. This act shall take effect upon becoming a
21 law.
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24 SENATE SUMMARY
25 Revises provisions that set forth the duties of the
Attorney General under the Medicaid fraud-control
26 program. Authorizes the Attorney General to seek civil
remedies for fraudulent activities. Provides that the
27 Attorney General refer cases of overpayment and suspected
abusive activities to the Agency for Health Care
28 Administration.
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