New Allegations Surface in RI Medicaid Fraud
Wednesday, March 27, 2013
Investigation into Medicaid fraud in Rhode Island reveals some starting findings, including more than $100,000 in overtim e at one taxpayer funded hospital.
The information that was uncovered regarding the state-run hospital comes on the heels of the recently released state Medicaid waste and fraud report, which closely scrutinized the Eleanor Slater Hospital for average costs of per patient care that far outpaced the national average.
The investigation by the Center for Freedom and Prosperity, a non-partisan public think tank and free-enterprise advocacy organization, found that in total for 2011, overtime payments at the Eleanor Slater Hospital amounted to approximately $1,485,346 for that year.
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTMike Stenhouse, CEO for the Center, announced that they would be releasing a broader list later this week of overtime payments made to other state employees. Next week, the Center plans to launch a module on its website, www.riOpenGov.org, listing regular and overtime compensation for all state employees.
"We are doing this for transparency purposes for the benefit of Rhode Islanders," said Stenhouse. "One has to wonder if the State of Rhode Island is defrauding itself, at taxpayer expense."
Eleanor Slater closely scrutinized in state Medicaid Fraud Report
Eleanor Slater Hospital was referenced in the recent Rhode Island Health and Human Services Waste and Fraud Project Summary as being an "extremely expensive option for long term care when compared with the state's nursing homes."
The report was conducted by Simpatico Software Systems based in Warwick, which is owned by Rhode Island Moderate Party Chairman and former gubernatorial candidate Ken Block. Investigations found the hospital to have an average cost of $957 per day per patient compared with an average nursing home cost of $155 per patient.
In an article that appeared Tuesday in the The Ocean State Current, David Burnett, Chief of Government and Public Affairs for the Executive Office of Health and Human Services (EOHHS), said that Eleanor Slater's unique mission makes it difficult to compare to other facilities. This hospital is licensed by the Rhode Island Department of Health, and treats patients with acute and long term medical illnesses, as well as patients with psychiatric disorders.
Burnett also explained that the Medicaid reimbursements are not based on fixed rates for service, but are based rather on the costs of particular facility, so if it costs more to run a hospital, it can charge Medicaid higher rates.
State addressing Medicaid fraud
In a statement released by the Governor's Office earlier this month, Governor Chafee said, "The challenges of eliminating waste, fraud, and abuse are in every state in the country, and here in Rhode Island my administration has been addressing them since my first year in office."
Listed on the state's "Stop Fraud" website is a timeline of actions taken by the state to address fraud, including recently implementing an "Electronic Disqualified Recipient" system to flag persons with intentional program violations in other states. In addition, the state has implemented systems to flag recipients with bad addresses.
Governor Chafee also unveiled a legislative package of four bills that "build upon the Governor's commitment to minimizing waste, fraud, and abuse by closing gaps and strengthening areas of weakness." A summary of those bills can be found on the Stop Fraud website.
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