Waltz Comments on New Medicaid Anti-Fraud Strategy

Partner Judith Waltz was quoted in a Bloomberg Law article, “Lawmakers to Grade New Medicaid Anti-Fraud Strategy,” about a plan by members of the Senate Governmental Affairs and Homeland Security Committee to grill the head of Medicare and Medicaid on her recently rolled-out strategy to curb Medicaid fraud and abuse.

Waltz said there’s a growing amount of pressure on the CMS to increase its focus on Medicaid fraud. “There’s apparently a fair amount of beneficiary fraud in enrollment and stolen identities that seems like it could be relatively easy to address,” she said.

Tackling Medicaid managed care plan fraud is more difficult and requires a thorough review of Medicaid records to pinpoint fraud, Waltz said, adding that it’s especially hard to get a handle on provider fraud against Medicaid managed care plans because many plans basically pay providers on a fee-for-service basis.