JOHNSON BILL TO INCREASE MEDICAID FRAUD PENALTIES RELEASED BY ASSEMBLY COMMITTEE

(TRENTON) – Legislation sponsored by Assemblyman Gordon Johnson (D-Bergen) to further protect taxpayers by increasing penalties for Medicaid fraud was released unanimously Thursday by an Assembly panel.

The bill (A-3015) increases penalties for committing Medicaid fraud to strengthen efforts to combat attempts to cheat the program of state and federal funds that are intended to serve the health care needs of the medically indigent.

“This money is supposed to be paying for the health care needs for our poorest residents,” Johnson said. “Taxpayers expect it to do just that, not wind up being wasted through fraud and abuse that serves no one but the greedy and dishonest. We need to send a stronger message and this bill does just that in this tough budget year.”

The bill is intended to ensure that the decision not to impose a jail sentence in a Medicaid fraud case – as well as other fraud involving public agencies or public funds – is given especially careful consideration by the sentencing court, since the matter involves fraud against the public.

The bill:

·Upgrades certain offenses involving Medicaid fraud from a “high misdemeanor” to a crime of the third degree punishable by a fine or by imprisonment for between three and five years, or both, or a crime of the fourth degree punishable by a fine or by imprisonment for not more than 18 months, or both;

·Creates new mandatory monetary penalties for Medicaid fraud offenses, which are in addition to any other penalty that may be imposed by law, of not less than $15,000 and not more than $25,000 for a crime of the third degree, and not less than $10,000 and not more than $25,000 for a crime of the fourth degree;

·Provides that the presumption against imprisonment for persons who have not been previously convicted of an offense, will not apply to an offense involving Medicaid fraud that is defined as a crime of the third degree under this bill; and

·Creates a new crime of the second degree, with a monetary penalty of not less than $25,000 and not more than $150,000, for persons convicted of repeated Medicaid fraud offenses under certain circumstances, specifically, where the aggregate amount obtained or sought to be obtained is $1,000 or more, and the person has previously been convicted of such a violation within 10 years of the current violation, under circumstances where the aggregate amount obtained or sought to be obtained was also $1,000 or more.

The bill further directs the Attorney General to when a person who is licensed or otherwise authorized to practice a health care profession and who has been convicted of Medicaid fraud refer that matter to the appropriate professional and occupational licensing board within the Division of Consumer Affairs or to the director of the division, for such action as they determine appropriate regarding that person’s license or other authorization to practice as a health care professional.

Johnson noted that nothing in this bill is to be construed to preclude the indictment or conviction for any other offense defined by law, or to impair or limit the discretion and authority of the state regarding any civil action, criminal prosecution, or other action authorized by law.

The bill was released by the Assembly Budget Committee and is expected to be heard Monday by the full Assembly.

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