The state of Florida made $70.3 million in Medicaid payments to providers who had fraud allegations against them, according to an audit from the inspector general.
The Office of Medicaid Program Integrity is charged with investigating and auditing providers that are thought to have defrauded or overbilled the state’s Medicaid program. Since 2011, if a provider has a credible fraud allegation, the state must suspend all Medicaid payments to that provider.
The auditors found that Florida did not always suspend payments to providers in these cases. The inspector general reviewed 95 cases and found that in more than half of them, Florida did not suspend Medicaid payments totaling $70,257,156 when there was a fraud investigation pending, putting these Medicaid funds at risk.
There were four cases in which fraud investigations were pending and the state did not suspend Medicaid payments. These payments totaled $13,827,876, including a federal share of $8,056,973 that was not eligible for reimbursement.