HB110 Alabama 2013 Session

This bill would enact The Medicaid Fraud Reduction Act of 2013.

Under existing law, certain designated persons or entities are granted access information in the Controlled Substances Prescription Database of the Department of Public Health.

This bill would grant access to the database to authorized representatives of the Medicaid Agency investigating claims of potential fraud, abuse, or misuse of controlled substances by Medicaid recipients or providers.

Under existing law, a person who makes a false statement or representation of material fact in claim or application for payments on medical benefits from the Medicaid Agency is guilty of a felony. Prosecution for a felony offense is required to be commenced within three years of the offense and prosecution for a misdemeanor is required to be commenced within 12 months of the offense.

This bill would rewrite the above law and would expand the list of prohibited fraudulent conduct and would provide felony and misdemeanor criminal penalties. The bill would also define "person" to include corporations and other entities and would provide that the statute of limitations for all offenses under this law would be six years.

Amendment 621 of the Constitution of Alabama of 1901, now appearing as Section 111.05 of the Official Recompilation of the Constitution of Alabama of 1901, as amended, prohibits a general law whose purpose or effect would be to require a new or increased expenditure of local funds from becoming effective with regard to a local governmental entity without enactment by a 2/3 vote unless: it comes within one of a number of specified exceptions; it is approved by the affected entity; or the Legislature appropriates funds, or provides a local source of revenue, to the entity for the purpose.

The purpose or effect of this bill would be to require a new or increased expenditure of local funds within the meaning of the amendment. However, the bill does not require approval of a local governmental entity or enactment by a 2/3 vote to become effective because it comes within one of the specified exceptions contained in the amendment.

Relating to Medicaid fraud; to enact The Medicaid Fraud Reduction Act of 2013; to amend Section 20-2-214, Code of Alabama 1975, relating to the Department of Public Health's Controlled Substances Prescription Database, to grant database access to certain authorized representatives of the Alabama Medicaid Agency investigating claims of potential fraud, abuse, or misuse of controlled substances by Medicaid recipients or providers; to amend Section 22-1-11 of the Code of Alabama 1975, relating to Medicaid fraud, to prohibit certain fraudulent conduct in obtaining medical benefits from the Medicaid Agency, to provide for a definition of person under the law, and to provide for a statute of limitations; and in connection therewith to have as its purpose or effect the requirement of a new or increased expenditure of local funds within the meaning of Amendment 621 of the Constitution of Alabama of 1901, now appearing as Section 111.05 of the Official Recompilation of the Constitution of Alabama of 1901, as amended.