Parker’s Medicaid fraud prevention bill passes state House
6th District lawmaker’s legislation could save state millions of dollars each year
A bill sponsored by Rep. Kevin Parker aimed at combating Medicaid fraud and saving the state millions of dollars passed the state House late Monday night on a 96-1 vote. House Bill 2571, which has four Democratic co-sponsors, would move the state forward in reforming outdated systems and practices in the state’s Health Care Authority.
“Medicaid fraud has become an epidemic – from organized crime to petty crime. This abuse of the system and tax dollars is shredding our safety net and services for our most vulnerable. This legislation would give our state the tools it needs to combat this fraud and abuse,” said Parker, R-Spokane. “It has taken significant negotiations with Republicans, Democrats, the Health Care Authority, and governor’s office to get to this point. I see this spirit of collaboration continuing in the legislative process.”
House Bill 2571 would direct the state Health Care Authority to explore technologies available in the private sector that include:
- predictive modeling and analytics technologies to find patterns that represent high risks of fraudulent activity and prevent payment of suspect claims until the claims have been verified as valid;
- provider and enrollee data verification technologies; and
- investigation services that combine retrospective and prospective analyses of waste, fraud and abuse.
House Bill 2571 would also encourage the state Health Care Authority to issue a request for proposals to implement these types of technologies, if state savings are expected to be generated.
Parker believes savings to the state could be significant if fraud is found and eliminated. If 1 percent of fraud is eliminated, savings could be around $30 million. Three percent could equate to $60 million in savings, and 5 percent could save $150 million.
“Modernizing our systems within the Health Care Authority and utilizing practices employed in the private sector are good for our state and those who rely on Medicaid,” said Parker. “The goal is to transition from a retrospective, ‘pay-and-chase’ model to a more prospective, prepayment model.”
House Bill 2571 now heads to the Senate for consideration. The 60-day legislative session is scheduled to adjourn March 8.
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Contact: John Handy, Deputy Communications Director, (360) 786-5758
