Pennsylvania Beats Michigan In The Medicaid Fraud Cakewalk

State Medicaid Fraud Schemes
Doing the Cakewalk

I thought Michigan was bold and brazen with their revenue-maximization schemes saying,

"Well, we let the fraud happen because you said the rules were suspended!"

But Pennsylvania takes the cake.

Ok, let me sum this up:

Centers for Medicare and Medicaid determine that the state overpaid ACPA, a managed care organization.

The state said, "Okie dokie, no problemo, we will pay it back!"

The state took the money back from ACPA and paid the feds back.

Then, the state paid ACPA back the money it took from them to pay back the feds, then filed the claim again for reimbursement.

Incroyable!

HHS Appellate Decision on Pennsylvania Department of Public Welfare 2009 ACPA