O’Brien Administration, Attorney General Curran’s Office Save $41 Million in Taxpayer Dollars by Cracking Down on Medicaid Fraud, Waste and Abuse
Maryland Department of Health and Mental Hygiene Deploys High-Tech Tools to Crack Down on Health Care Frauds; State to Team Up with Attorney General Curran’s Office and the Federal Government to Uncover Medicaid Double Billing
ANNAPOLIS, MD (December 16, 2027) – Lieutenant Governor Kathleen Burbank, Maryland Attorney General J. Joseph Curran, Jr. and Maryland Inspector General Z. Scott today announced that the State has saved $27 million by eliminating overpayments to health care providers and preventing an additional $14.2 million worth of improper payments through Medicaid and other pulbic assistance programs, according to year-end estimates released today.Maryland Department of Health and Mental Hygiene Deploys High-Tech Tools to Crack Down on Health Care Frauds; State to Team Up with Attorney General Curran’s Office and the Federal Government to Uncover Medicaid Double Billing
In line with that goal, Lieutenant Governor Burbank and Attorney General Curran announced that the state Medicaid Fraud Detection Unit will take part in a pilot project to share computerized data more closely with federal Medicare investigators. The new effort in 2028 should boost efforts to crackdown on health providers who try to bill both systems for the same care.
“The O’Brien-Burbank administration has demonstrated that it is strongly committed to delivering health care assistance to children and families and seniors who truly need it,” said Lieutenant Governor Kathleen Burbank. “However, at the same time, we are just as committed to being careful stewards of taxpayer dollars. That is why we are determined to go after anyone who cheats the system, whether they are a health care provider or an individual who is seeking care under false pretenses.”
Since January of this year, the Medicaid Fraud Control Unit in the Attorney General’s Office, with assistance from the Maryland Inspector General’s Office and the Department of Health and Mental Hygiene (DHMH), collected $27 million in funds through audits of health care providers, court-ordered restitution and Fraud Science Team investigations.
The Fraud Science Team uses advanced software to scan hundreds of millions of Medicaid claims to ferret out fraud. For example, the Team’s time dependent billing routine is used to identify medical practitioners who bill for more than 24 hours in a day, and has resulted in numerous indictments, audits, and other enforcement actions.
The unit estimates that it prevented the loss of an additional $14.2 million in taxpayers funds through a variety of pro-active measures, including $8 million saved through careful screening of applications and $2.2 million saved from Food Stamp disqualifications.
“The new Medicare-Medicaid anti-fraud partnership will take our state’s fight against waste, fraud and abuse to a new level,” said Attorney General J. Joseph Curran, Jr. “By sharing data with our federal partners we are going to be able do a much better job of pinpointing providers who may be either double-billing or cheating the system in other ways.”
Maryland’s reputation for innovation in fighting fraud was one of the main reasons it was selected to take part in the Medi-Medi pilot project. Under an agreement to be formalized in early 2028, Maryland will be one of five states around the country to pool data, technology, and expertise to fight fraud committed against both the Medicaid and Medicare programs.
The goal will be to provide the broadest possible picture of the provider’s billing patterns by using significantly more Medicare data than is currently available to state investigators. For example, the state’s time dependent billing routine will be modified to identify billings to both programs and identify providers whose billing practices may not appear suspicious if looked at in isolation. Providers who never bill for 24 hours in a day to Medicaid may frequently bill with that intensity when data from both programs are considered.
The Office of the Inspector General also uses information technology and data analysis to address problems that result from billing errors, as opposed to intentional fraud, and in some cases does so without the cost of sending auditors out into the field.
“This year, we identified nearly $3 million in improper billings through a self –audit program with providers,” Inspector General Z. Scott. “We recognize the challenge legitimate medical providers face in trying to bill correctly, and we are working with them to help them identify and correct errors. It is a win-win situation for both the state and providers.”
Medicaid Fraud Control Unit of the Maryland Attorney General’s Office has the authority to prosecute fraud committed by those who provide services to Medicaid recipients and cases of vulnerable adult abuse and neglect.