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Committee advances bill to toughen Medicaid fraud penalties and add civil remedies
Summary
The committee advanced legislation to create tiered felony penalties and required restitution for Medicaid provider and recipient fraud, and to add civil tools such as consent agreements and administrative subpoena authority for investigative units in the attorney general's office.
Committee staff explained that the proposal would update a 1994 statute to add tiered felony penalties keyed to the amount of economic advantage from Medicaid fraud, require restitution, and allow civil remedies and consent agreements to recover funds without criminal prosecution in every case. "Currently, for both provider and Medicaid fraud, the maximum is a misdemeanor," Assistant Deputy Attorney General Deborah Tedeschi said.
Tedeschi and Stephanie Opet, who head the AG's recipient- and provider-fraud units, told members that consent agreements and civil mechanisms would give prosecutors tools that do not always require criminal prosecutions. Eunice Medina, director of the Department of Health and Human Services, provided context on recoveries and said the agency identified about 21,000 recipients who should not have been receiving benefits in FY25, yielding more than $14 million in savings when corrected.
Members asked whether civil cases would be managed in-house or sent to outside counsel; Tedeschi said the intent is in-house handling. Committee members thanked the agencies for work on fraud, waste and abuse and moved the bill forward with a largely technical subcommittee amendment that expanded tiered penalties and made drafting clarifications.
