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S.B. 1

Senate Floor Amendments

Amendment 9 February 28, 2000 3:11 PM

Senator Leonard M. Blackham proposes the following amendments:

1.    Page 7, Line 193:    After line 193 insert:
        "It is the intent of the Legislature that the Attorney General use these funds to develop a comprehensive Medicaid fraud detection, investigation, and prosecution program. Recent history demonstrates that, to be effective, a comprehensive program must include the following elements: a) credible processes for identifying potential fraud situations; b) expert medical advice to distinguish acceptable community practice from potentially fraudulent medical practice; c) expert legal guidance to distinguish between civil and criminal situations, with appropriate legal remedies defined for each, and for the civil component it is the Legislature's intent that the Attorney General enter into a memorandum of agreement with the Department of Health to perform these functions; d) strong due process guidelines to assure medicaid providers of fair and respectful treatment; e) well developed employee training programs to insure staff understand their missions and conduct in performing that mission; and f) well developed processes that distinguish between field audits, potential fraud discovery, and criminal seizures of records. Further, the Attorney General shall insure that this comprehensive Medicaid Fraud Program is administered in a manner that allocates a proportionate measure of fraud detection effort to urban Medicaid providers. This will require the Attorney General to develop methodologies and tools for assessing potential Medicaid fraud under the managed care arrangements in use on the Wasatch Front. Finally, it is the intent of the Legislature that the Attorney General shall report to the 2001 Legislature regarding its success in complying with this intent statement."