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§ 25.5-1-115.5. Medical assistance fraud - report

CO Rev Stat § 25.5-1-115.5 (2018) (N/A)
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(1) Notwithstanding the provisions of section 24-1-136 (11)(a)(I), on or before November 1, 2017, and on or before November 1 each year thereafter, the state department shall submit a written report to the joint budget committee; the judiciary committee and the public health care and human services committee of the house of representatives, or their successor committees; and to the judiciary committee and the health and human services committee of the senate, or their successor committees, concerning fraud in the medicaid program. The state department shall compile a single, comprehensive report that includes the information described in this subsection (1), as well as information that the attorney general provides to the state department pursuant to section 25.5-4-303.3. The state department shall report to the general assembly concerning the fraudulent receipt of medicaid benefits, including, at a minimum:

(a) Investigations of client fraud during the year;

(b) Termination of client medicaid benefits due to fraud;

(c) District attorney action, including, at a minimum, criminal complaints requested, cases dismissed, cases acquitted, convictions, and confessions of judgment;

(d) Recoveries, including fines and penalties, restitution ordered, and restitution collected;

(e) Trends in methods used to commit client fraud, excluding law enforcement-sensitive information; and

(f) An estimate of the total savings, total cost, and net cost-effectiveness of fraud detection and recovery efforts.

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