On January 13, 2020, a bipartisan coalition of Pennsylvania lawmakers along with the Pennsylvania Attorney General announced a comprehensive package of fraud prevention legislation aimed at protecting the integrity of Pennsylvania’s Medical Assistance (Medicaid) Program. Included in the package of anti-fraud bills introduced Monday morning is legislation implementing a State False Claims Act. Essentially a state version of the Federal False Claims Act, the legislation would incentivize private individuals with knowledge of Medical Assistance fraud, waste, and abuse to come forward as whistleblowers and bring lawsuits on the Commonwealth’s behalf.
With more than 2.9 million Pennsylvania residents enrolled in Medical Assistance, preventing fraud has been a recent priority for lawmakers in the Commonwealth, especially since a Grand Jury Report in April 2019 recommended widespread reforms to the Pennsylvania Medical Assistance Program. While this package of fraud prevention legislation has been announced, the actual bills are not expected to be introduced until the spring. We will continue to monitor this proposed legislation and provide updates as more information becomes available.