HB 353 -- Medicaid Fraud and Abuse

Sponsor:  Schaaf

This bill changes the laws regarding fraud and abuse in the
Missouri Medicaid Program.  The bill:

(1)  Specifies that the terms "knowing" and "knowingly" mean
intentionally;

(2)  Changes the penalty for making a false statement to a class
C felony for a first conviction and a class B felony for
subsequent convictions.  A person who attempts to or willfully
prevents, obstructs, misleads, or delays the communication of
information relating to a violation will be guilty of a class D
felony;

(3)  Specifies that any person who is the original source of
information regarding a violation will be compensated unless he
or she participated in the fraud or abuse;

(4)  Prevents an employer from discriminating against an employee
for participating in a court action relating to a violation
unless the employee filed a frivolous claim, participated in the
violation, or is convicted of criminal conduct related to the
violation;

(5)  Requires the Office of the Attorney General and the
Department of Social Services to report information regarding
violations to the Governor and General Assembly by January 1,
2008, and annually thereafter;

(6)  Requires the State Auditor to complete a financial audit of
the Medicaid fraud unit within the Office of the Attorney General
and the program integrity unit within the Department of Social
Services;

(7)  Establishes a penalty for destroying or concealing records
of claims submitted or payments received;

(8)  Establishes a penalty for filing false reports or claims of
alleged violations and receiving compensation for failure to
report violations; and

(9)  Creates an advisory working group, beginning September 1,
2007, to determine the need for an Office of Inspector General to
oversee the state's medical assistance programs.

Missouri House of Representatives
94th General Assembly, 1st Regular Session
Last Updated July 25, 2007 at 11:18 am