New training to detect Medicaid fraud - WCAX.COM Local Vermont News, Weather and Sports-

New training to detect Medicaid fraud

Burlington, Vermont - November 4, 2010

Medicaid fraud costs taxpayers millions in this state each year. Now the Vermont Attorney General's office is working with state agencies on how to better detect that fraud and stop it.

Last month Dr. Peter Gray, a dental surgeon in Rutland, was charged with almost two dozen felony counts of medicaid fraud. Prosecutors say it's the latest example of a provider or a patient stealing from the taxpayers. Now the state is taking steps to combat the growing problem.

"It is as bad here as it is anywhere in the country," said Ed Baker, a Vermont Assistant Attorney General who helped organize the Health Care Fraud 101 training session for state employees in Waterbury. "To educate state employees who are involved in health care law enforcement about what fraud is and how we prosecute and prevent it in the state," he said.

On average, about 170 billion dollars in the U.S. is lost to Medicaid fraud every year. Vermont looses an estimated 3 to 9 million dollars out of its 209 million dollar budget. "We've sort of, not ignored fraud, but we have sort of trusted each other. Vermont is a very trusting state," said Ron Clark, with the Vermont Department of Health Access.

Vermont's Medicaid fraud handles hundreds of investigations every year and experts say there are dozens of ways violators could potentially steal from taxpayers. "There's some providers billing for things they shouldn't be billing for," Clark said.

"Fraud occurring in nursing homes -- people are taking drugs from patients who are meant to receive it -- like pain medication," Baker said.

Officials are confident that keeping a close eye on fraud will decrease the chances of those getting away with it. "Now with the emphasis on it, we're really looking at it very closely and very carefully," Clark said.

The program is a collaborative effort between the Attorney General's office and Vermont's Department of Health Access.

Melinda Davenport - WCAX News

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