Congressman Biggs Takes Action to Fight Medicaid Fraud Across the United States

GILBERT, ARIZONA - Congressman Andy Biggs (AZ-05) co-sponsored H.R. 10636, the Medicaid Fraud Prevention Act, legislation requiring states to strengthen their efforts to identify and combat fraud, waste, and abuse in their Medicaid programs.

Under the legislation, states would be required to conduct a comprehensive Medicaid fraud risk assessment at least once each year. The assessments would identify and rank the most significant fraud, waste, and abuse vulnerabilities, estimate the amount of taxpayer dollars potentially at risk of improper expenditure, evaluate the effectiveness of existing program integrity tools, and identify gaps in data sharing, oversight, and enforcement.

The legislation follows a recent warning from the Administrator of the Centers for Medicare & Medicaid Services that Arizona was one of eight states reporting "zero fraud referrals and overpayments recovered in Medicaid managed care." The Administrator gave the states "30 days to double-check their numbers and make sure oversight is happening on the ground."

The warning adds to growing concerns about Arizona's oversight of federal taxpayer dollars.

Earlier this year, Gustav Chiarello, Assistant Secretary for Financial Resources at the U.S. Department of Health and Human Services, informed Arizona Governor Katie Hobbs that the state had failed to comply with the federal Single Audit deadline for four consecutive fiscal years. States receiving federal funding, including Medicaid dollars, are required to submit annual audits examining financial reporting and compliance with federal requirements. Continued failure to meet those requirements could jeopardize Arizona's eligibility for certain federal HHS funding. Arizona's overall Medicaid improper payment rate is estimated to be over six percent.

"For far too long, governments at every level have allowed a festering culture of fraud and waste of monumental proportions across the United States,"said Congressman Biggs."Government officials have a responsibility to be good stewards of taxpayer dollars and ensure that Americans' hard-earned money is spent appropriately and protected from fraud. Unfortunately, under the current state administration, Arizona has been an unwilling participant in the critical effort to hold bad actors accountable and root out fraud wherever it exists.

"I'm pleased to co-sponsor the Medicaid Fraud Prevention Act to establish a clear baseline for states to identify fraud, recover improper payments, and correct deficiencies in their Medicaid programs. Arizona officials must take these responsibilities seriously. Taxpayers deserve accountability, and continued failures in oversight risk both federal funding and the public's trust."

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