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The DOJ’s expanded anti-fraud task force made its first sweeping bust of Medicaid scofflaws in Pennsylvania this month, drawing comparisons to the massive fraud scandals that rocked Minnesota — but with one major difference.
Republicans and Democrats in the state united in outrage after nearly two dozen people were charged in Philadelphia and elsewhere. The DOJ noted Pennsylvania spends $8 billion on Medicaid home-care services, more than almost any other state, and those services were the target of the busts.
“The allegations are really disturbing just as they are in Minnesota and other places where we’ve seen this,” House Ways & Means Committee member Lloyd Smucker, R-Pa., told Fox News Digital in an exclusive interview.
PENNSYLVANIA AG EXPLAINS WHY STATE LEADS NATION IN MEDICAID FRAUD CONVICTIONS WHILE OTHERS BATTLE MASS SCHEMES
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PROCUREMENT & EXPENDITURE (STOPPING KICKBACKS)
Procurement fraud usually involves inflated invoices or “fictitious” vendors.
- The Three-Way Match: Never pay an invoice unless you have matched the Purchase Order (PO), the Delivery Note (signed), and the Supplier Invoice.
- Vendor Master File Review: Review your vendor list annually. Look for suppliers with the same bank details or physical addresses as your employees.
- Dual Authorization: Implement a “Two-to-Sign” rule for all EFT payments above a certain threshold (e.g., R5,000).
- No “Cashing” of Checks: If you still use physical checks, strictly prohibit “Cash” as a payee and store blank checks in a dual-lock safe.