HB 18-1211

HB 18-1211, also known as the Medicaid Fraud Control Unit bill, establishes a new unit within Colorado’s Department of Law. This unit is tasked with investigating and prosecuting cases related to Medicaid fraud, waste, patient abuse, neglect, and exploitation. The bill requires that before any criminal prosecution begins, the unit must consult with local district attorneys. It also mandates that Medicaid providers inform beneficiaries about how to report suspected fraud. Signed into law, this means the measures are now in effect and aim to protect Medicaid funds and patients from harm and misuse.

Official Summary

The bill establishes the medicaid fraud control unit (unit) in the department of law. The unit is responsible for investigation and prosecution of medicaid fraud and waste, as well as patient abuse, neglect, and exploitation. Prior to initiating a criminal prosecution, the unit must consult with the district attorney of the judicial district where the prosecution would be initiated. The department of health care policy and financing is authorized to require medicaid providers to include information about reporting medicaid fraud to the unit in any explanation of benefits provided to a medicaid beneficiary. The bill creates offenses related to making false statements on applications, medicaid fraud, and credit and recovery of medicaid payments. The bill makes it unlawful to receive certain kickbacks, bribes, and rebates related to the administration of a medicaid service. Actions brought under the provisions of the bill must commence within 3 years after the discovery of the offense, but no later than six years after the commission of the offense. (Note: This summary applies to the reengrossed version of this bill as introduced in the second house.) , Read More

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