When it comes to Medicaid, Georgia is mostly known for choosing not to expand the health care program for the poor, disabled and elderly under the federal Affordable Care Act.
But the state is also gaining attention for the efforts by Attorney General Sam Olens and the Georgia Department of Community Health to crack down on the pilfering of Medicaid money. A Pew Charitable Trusts’ study ranks Georgia sixth nationally in fiscal 2012 after recovering nearly $100 million in Medicaid funds from fraud cases, according to federal records. Only Texas, New York, California, Florida and Louisiana recovered more.
That figure includes every dollar defendants in criminal and civil cases are required to pay back to the general fund, sometimes over many years. Rob Finlayson, the inspector general for the Department of Community Health, which administers Medicaid in Georgia, said actual dollars returned to the state and federal government totaled more than $56 million in the past two fiscal years.
The Georgia Medicaid Fraud Unit’s mission to stop those who defraud the system is increasingly important. More than 1.5 million Georgians are enrolled in Medicaid at a cost to the state of more than $2.5 billion a year — an increase of $300 million in just the past two years.
And no state has done more with less. Georgia had 36 people in its Medicaid fraud unit in 2012, a team that produced a national-best ratio of recoveries per employee.