Introduced Version






SENATE BILL No. 461

_____


DIGEST OF INTRODUCED BILL



Citations Affected: IC 4-6-10 ; IC 12-15-23 ; IC 33-14-1-4.

Synopsis: Medicaid fraud control unit authority. States that the state Medicaid fraud control unit has the authority to investigate Medicaid fraud and abuse and neglect of Medicaid patients and patients in board and care facilities in accordance with federal law. Authorizes a court to order a provider to reimburse the attorney general for the reasonable costs of the attorney general's investigation and enforcement of Medicaid fraud. (Current law limits the award to $500.) Makes conforming amendments.

Effective: July 1, 2003.





Miller




    January 21, 2003, read first time and referred to Committee on Health and Provider Services.







Introduced

First Regular Session 113th General Assembly (2003)


PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional provision adopted), the text of the new provision will appear in this style type. Also, the word NEW will appear in that style type in the introductory clause of each SECTION that adds a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts between statutes enacted by the 2002 Regular or Special Session of the General Assembly.

SENATE BILL No. 461



    A BILL FOR AN ACT to amend the Indiana Code concerning Medicaid.

Be it enacted by the General Assembly of the State of Indiana:

    SECTION 1. IC 4-6-10-1.5 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 1.5. The state Medicaid fraud control unit has the authority to:
        (1) investigate, in accordance with federal law (42 U.S.C.1396 et seq.):
            (A) Medicaid fraud;
            (B) abuse of Medicaid patients; and
            (C) neglect of Medicaid patients; and
        (2) investigate, in accordance with federal law (42 U.S.C. 1396 et seq.) and as allowed under 42 U.S.C. 1396b(q)(4)(A)(ii), abuse of patients in board and care facilities.

    SECTION 2. IC 4-6-10-3 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 3. The attorney general and an investigator of the Medicaid fraud control unit, when engaged in:
        (1) an investigation of an alleged offense involving Medicaid fraud; or


        (2) the prosecution of an alleged offense involving Medicaid fraud, abuse of a Medicaid recipient, or neglect of a Medicaid recipient investigated under section 1.5 of this chapter or that has been referred to the attorney general under IC 12-15-23-6 ;
may issue, serve, and apply to a court to enforce, a subpoena for a witness to appear before the attorney general in person to produce books, papers, or other records, including records stored in electronic data processing systems, for inspection and examination.
    SECTION 3. IC 12-15-23-6 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 6. (a) If the state Medicaid fraud control unit determines that an action based on the state Medicaid fraud control unit's investigations under the unit's authority under IC 4-6-10-1.5 is meritorious, the unit shall certify the facts drawn from the investigation to the prosecuting attorney of the judicial circuit in which the crime may have been committed.
    (b) The state Medicaid fraud control unit shall assist the prosecuting attorney in prosecuting an action under this section.
    (c) A prosecuting attorney to whom facts concerning alleged Medicaid fraud are certified under subsection (a) may refer the matter to the attorney general.
    (d) If a matter has been referred to the attorney general under subsection (c), the attorney general may:
        (1) file an information in a court with jurisdiction over the matter in the county in which the offense is alleged to have been committed; and
        (2) prosecute the alleged offense.
    SECTION 4. IC 12-15-23-8 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 8. (a) Subject to subsection (b), if the court finds in favor of the attorney general in a civil action brought by the attorney general under section 7 of this chapter, the court may do the following:
        (1) Award damages against the provider of not more than three (3) times the amount paid to the provider in excess of the amount that was legally due.
        (2) Assess a civil penalty against the provider of not more than five hundred dollars ($500) for each instance of overpayment found by the court.
        (3) Order the provider to reimburse the attorney general for the reasonable costs of the attorney general's investigation of not more than five hundred dollars ($500). and enforcement action.
        (4) Take any combination of the actions described in subdivisions (1), (2), and (3).
    (b) The court may only take action under subsection (a)(2) and (a)(3) if the provider knew or had reason to know that an item or a service was not provided as claimed.
    SECTION 5. IC 33-14-1-4 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 4. Except as provided in IC 4-6-10-1.5 and IC 12-15-23-6 (d), the prosecuting attorneys, within their respective jurisdictions, shall conduct all prosecutions for felonies, misdemeanors, or infractions and all suits on forfeited recognizances; and superintend, on behalf of counties or any of the trust funds, all suits in which the same may be interested or involved, and shall perform all other duties required by law.