Bill Text: FL S0008 | 2010 | Regular Session | Engrossed

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Bill Title: Medicaid and Public Assistance Fraud [CPSC]

Spectrum: Slight Partisan Bill (Republican 3-1)

Status: (Failed) 2010-04-30 - Died in Messages, companion bill(s) passed, see CS/CS/SB 1484 (Ch. 2010-144) [S0008 Detail]

Download: Florida-2010-S0008-Engrossed.html

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CS for CS for SB 8                               First Engrossed 
20108e1 
1                        A bill to be entitled 
2         An act relating to Medicaid and public assistance 
3         fraud; creating s. 624.35, F.S.; providing a short 
4         title; creating s. 624.351, F.S.; providing 
5         legislative intent; establishing the Medicaid and 
6         Public Assistance Fraud Strike Force within the 
7         Department of Financial Services to coordinate efforts 
8         to eliminate Medicaid and public assistance fraud; 
9         providing for membership; providing for meetings; 
10         specifying duties; requiring an annual report to the 
11         Legislature and Governor; creating s. 624.352, F.S.; 
12         directing the Chief Financial Officer to prepare model 
13         interagency agreements that address Medicaid and 
14         public assistance fraud; specifying which agencies can 
15         be a party to such agreements; amending s. 16.59, 
16         F.S.; conforming provisions to changes made by the 
17         act; requiring the Divisions of Insurance Fraud and 
18         Public Assistance Fraud in the Department of Financial 
19         Services to be collocated with the Medicaid Fraud 
20         Control Unit if possible; requiring positions 
21         dedicated to Medicaid managed care fraud to be 
22         collocated with the Division of Insurance Fraud; 
23         amending s. 20.121, F.S.; establishing the Division of 
24         Public Assistance Fraud within the Department of 
25         Financial Services; amending ss. 411.01, 414.33, and 
26         414.39, F.S.; conforming provisions to changes made by 
27         the act; transferring, renumbering, and amending s. 
28         943.401, F.S.; directing the Department of Financial 
29         Services rather than the Department of Law Enforcement 
30         to investigate public assistance fraud; creating s. 
31         409.91212, F.S.; requiring Medicaid managed care plans 
32         to adopt an anti-fraud plan relating to the provision 
33         of health care services; requiring certain managed 
34         care plans to also establish an investigative unit or 
35         contract for the investigation of fraudulent or 
36         abusive activity; requiring an annual report; 
37         providing administrative penalties for noncompliance; 
38         authorizing the Agency for Health Care Administration 
39         to adopt rules; directing the Auditor General and the 
40         Office of Program Policy Analysis and Government 
41         Accountability to review the Medicaid fraud and abuse 
42         processes in the Agency for Health Care 
43         Administration; requiring a report to the Legislature 
44         and Governor by a certain date; establishing the 
45         Medicaid claims adjudication project in the Agency for 
46         Health Care Administration to decrease the incidence 
47         of inaccurate payments and to improve the efficiency 
48         of the Medicaid claims processing system; transferring 
49         activities relating to public assistance fraud from 
50         the Department of Law Enforcement to the Division of 
51         Public Assistance Fraud in the Department of Financial 
52         Services by a type two transfer; providing effective 
53         dates. 
54 
55         WHEREAS, Florida’s Medicaid program is one of the largest 
56  in the country, serving approximately 2.7 million persons each 
57  month. The program provides health care benefits to families and 
58  individuals below certain income and resource levels. For the 
59  2008-2009 fiscal year, the Legislature appropriated $18.81 
60  billion to operate the Medicaid program which is funded from 
61  general revenue, trust funds that include federal matching 
62  funds, and other state funds, and 
63         WHEREAS, Medicaid fraud in Florida is epidemic, far 
64  reaching, and costs the state and the Federal Government 
65  billions of dollars annually. Medicaid fraud not only drives up 
66  the cost of health care and reduces the availability of funds to 
67  support needed services, but undermines the long-term solvency 
68  of both health care providers and the state’s Medicaid program, 
69  and 
70         WHEREAS, the state’s public assistance programs serve 
71  approximately 1.8 million Floridians each month by providing 
72  benefits for food, cash assistance for needy families, home 
73  health care for disabled adults, and grants to individuals and 
74  communities affected by natural disasters. For the 2008-2009 
75  fiscal year, the Legislature appropriated $626 million to 
76  operate public assistance programs, and 
77         WHEREAS, public assistance fraud costs taxpayers millions 
78  of dollars annually, which significantly and negatively impacts 
79  the various assistance programs by taking dollars that could be 
80  used to provide services for those people who have a legitimate 
81  need for assistance, and 
82         WHEREAS, both Medicaid and public assistance programs are 
83  vulnerable to fraudulent practices that can take many forms. For 
84  Medicaid, these practices range from providers who bill for 
85  services never rendered and who pay kickbacks to other providers 
86  for client referrals, to fraud occurring at the corporate level 
87  of a managed care organization. Fraudulent practices involving 
88  public assistance involve persons not disclosing material facts 
89  when obtaining assistance or not disclosing changes in 
90  circumstances while on public assistance, and 
91         WHEREAS, ridding the system of perpetrators who prey on the 
92  state’s Medicaid and public assistance programs helps reduce the 
93  state’s skyrocketing costs, makes more funds available for 
94  essential services, and improves the quality of care and the 
95  health status of our residents, and 
96         WHEREAS, aggressive and comprehensive measures are needed 
97  at the state level to investigate and prosecute Medicaid and 
98  public assistance fraud and to recover dollars stolen from these 
99  programs, and 
100         WHEREAS, new statewide initiatives and coordinated efforts 
101  are necessary to focus resources in order to aid law enforcement 
102  and investigative agencies in detecting and deterring this type 
103  of fraudulent activity, NOW, THEREFORE, 
104 
105  Be It Enacted by the Legislature of the State of Florida: 
106 
107         Section 1. Section 624.35, Florida Statutes, is created to 
108  read: 
109         624.35 Short title.—Sections 624.35-624.352 may be cited as 
110  the “Medicaid and Public Assistance Fraud Strike Force Act.” 
111         Section 2. Section 624.351, Florida Statutes, is created to 
112  read: 
113         624.351 Medicaid and Public Assistance Fraud Strike Force.— 
114         (1) LEGISLATIVE FINDINGS.—The Legislature finds that there 
115  is a need to develop and implement a statewide strategy to 
116  coordinate state and local agencies, law enforcement entities, 
117  and investigative units in order to increase the effectiveness 
118  of programs and initiatives dealing with the prevention, 
119  detection, and prosecution of Medicaid and public assistance 
120  fraud. 
121         (2) ESTABLISHMENT.—The Medicaid and Public Assistance Fraud 
122  Strike Force is created within the department to oversee and 
123  coordinate state and local efforts to eliminate Medicaid and 
124  public assistance fraud and to recover state and federal funds. 
125  The strike force shall serve in an advisory capacity and provide 
126  recommendations and policy alternatives to the Chief Financial 
127  Officer. 
128         (3) MEMBERSHIP.—The strike force shall consist of the 
129  following 11 members who may not designate anyone to serve in 
130  their place: 
131         (a) The Chief Financial Officer, who shall serve as chair. 
132         (b) The Attorney General, who shall serve as vice chair. 
133         (c) The executive director of the Department of Law 
134  Enforcement. 
135         (d) The Secretary of Health Care Administration. 
136         (e) The Secretary of Children and Family Services. 
137         (f) The State Surgeon General. 
138         (g) Five members appointed by the Chief Financial Officer, 
139  consisting of two sheriffs, two chiefs of police, and one state 
140  attorney. When making these appointments, the Chief Financial 
141  Officer shall consider representation by geography, population, 
142  ethnicity, and other relevant factors in order to ensure that 
143  the membership of the strike force is representative of the 
144  state as a whole. 
145         (4) TERMS OF MEMBERSHIP; COMPENSATION; STAFF.— 
146         (a) The five members appointed by the Chief Financial 
147  Officer will serve 4-year terms; however, for the purpose of 
148  providing staggered terms, of the initial appointments, two 
149  members will be appointed to a 2-year term, two members will be 
150  appointed to a 3-year term, and one member will be appointed to 
151  a 4-year term. The remaining members are standing members of the 
152  strike force and may not serve beyond the time he or she holds 
153  the position that was the basis for strike force membership. A 
154  vacancy shall be filled in the same manner as the original 
155  appointment but only for the unexpired term. 
156         (b) The Legislature finds that the strike force serves a 
157  legitimate state, county, and municipal purpose and that service 
158  on the strike force is consistent with a member’s principal 
159  service in a public office or employment. Therefore membership 
160  on the strike force does not disqualify a member from holding 
161  any other public office or from being employed by a public 
162  entity, except that a member of the Legislature may not serve on 
163  the strike force. 
164         (c) Members of the strike force shall serve without 
165  compensation, but are entitled to reimbursement for per diem and 
166  travel expenses pursuant to s. 112.061. Reimbursements may be 
167  paid from appropriations provided to the department by the 
168  Legislature for the purposes of this section. 
169         (d) The Chief Financial Officer shall appoint a chief of 
170  staff for the strike force who must have experience, education, 
171  and expertise in the fields of law, prosecution, or fraud 
172  investigations and shall serve at the pleasure of the Chief 
173  Financial Officer. The department shall provide the strike force 
174  with staff necessary to assist the strike force in the 
175  performance of its duties. 
176         (5) MEETINGS.—The strike force shall hold its 
177  organizational session by March 1, 2011. Thereafter, the strike 
178  force shall meet at least four times per year. Additional 
179  meetings may be held if the chair determines that extraordinary 
180  circumstances require an additional meeting. Members may appear 
181  by electronic means. A majority of the members of the strike 
182  force constitutes a quorum. 
183         (6) STRIKE FORCE DUTIES.—The strike force shall provide 
184  advice and make recommendations, as necessary, to the Chief 
185  Financial Officer. 
186         (a) The strike force may advise the Chief Financial Officer 
187  on initiatives that include, but are not limited to: 
188         1. Conducting a census of local, state, and federal efforts 
189  to address Medicaid and public assistance fraud in this state, 
190  including fraud detection, prevention, and prosecution, in order 
191  to discern overlapping missions, maximize existing resources, 
192  and strengthen current programs. 
193         2. Developing a strategic plan for coordinating and 
194  targeting state and local resources for preventing and 
195  prosecuting Medicaid and public assistance fraud. The plan must 
196  identify methods to enhance multiagency efforts that contribute 
197  to achieving the state’s goal of eliminating Medicaid and public 
198  assistance fraud. 
199         3. Identifying methods to implement innovative technology 
200  and data sharing in order to detect and analyze Medicaid and 
201  public assistance fraud with speed and efficiency. 
202         4. Establishing a program to provide grants to state and 
203  local agencies that develop and implement effective Medicaid and 
204  public assistance fraud prevention, detection, and investigation 
205  programs, which are evaluated by the strike force and ranked by 
206  their potential to contribute to achieving the state’s goal of 
207  eliminating Medicaid and public assistance fraud. The grant 
208  program may also provide startup funding for new initiatives by 
209  local and state law enforcement or administrative agencies to 
210  combat Medicaid and public assistance fraud. 
211         5. Developing and promoting crime prevention services and 
212  educational programs that serve the public, including, but not 
213  limited to, a well-publicized rewards program for the 
214  apprehension and conviction of criminals who perpetrate Medicaid 
215  and public assistance fraud. 
216         6. Providing grants, contingent upon appropriation, for 
217  multiagency or state and local Medicaid and public assistance 
218  fraud efforts, which include, but are not limited to: 
219         a. Providing for a Medicaid and public assistance fraud 
220  prosecutor in the Office of the Statewide Prosecutor. 
221         b. Providing assistance to state attorneys for support 
222  services or equipment, or for the hiring of assistant state 
223  attorneys, as needed, to prosecute Medicaid and public 
224  assistance fraud cases. 
225         c. Providing assistance to judges for support services or 
226  for the hiring of senior judges, as needed, so that Medicaid and 
227  public assistance fraud cases can be heard expeditiously. 
228         (b) The strike force shall receive periodic reports from 
229  state agencies, law enforcement officers, investigators, 
230  prosecutors, and coordinating teams regarding Medicaid and 
231  public assistance criminal and civil investigations. Such 
232  reports may include discussions regarding significant factors 
233  and trends relevant to a statewide Medicaid and public 
234  assistance fraud strategy. 
235         (7) REPORTS.—The strike force shall annually prepare and 
236  submit a report on its activities and recommendations, by 
237  October 1, to the President of the Senate, the Speaker of the 
238  House of Representatives, the Governor, and the chairs of the 
239  House of Representatives and Senate committees that have 
240  substantive jurisdiction over Medicaid and public assistance 
241  fraud. 
242         Section 3. Section 624.352, Florida Statutes, is created to 
243  read: 
244         624.352 Interagency agreements to detect and deter Medicaid 
245  and public assistance fraud.— 
246         (1) The Chief Financial Officer shall prepare model 
247  interagency agreements for the coordination of prevention, 
248  investigation, and prosecution of Medicaid and public assistance 
249  fraud to be known as “Strike Force” agreements. Parties to such 
250  agreements may include any agency that is headed by a Cabinet 
251  officer, the Governor, the Governor and Cabinet, a collegial 
252  body, or any federal, state, or local law enforcement agency. 
253         (2) The agreements must include, but are not limited to: 
254         (a) Establishing the agreement’s purpose, mission, 
255  authority, organizational structure, procedures, supervision, 
256  operations, deputations, funding, expenditures, property and 
257  equipment, reports and records, assets and forfeitures, media 
258  policy, liability, and duration. 
259         (b) Requiring that parties to an agreement have appropriate 
260  powers and authority relative to the purpose and mission of the 
261  agreement. 
262         Section 4. Section 16.59, Florida Statutes, is amended to 
263  read: 
264         16.59 Medicaid fraud control.—The Medicaid Fraud Control 
265  Unit There is created in the Department of Legal Affairs to the 
266  Medicaid Fraud Control Unit, which may investigate all 
267  violations of s. 409.920 and any criminal violations discovered 
268  during the course of those investigations. The Medicaid Fraud 
269  Control Unit may refer any criminal violation so uncovered to 
270  the appropriate prosecuting authority. The offices of the 
271  Medicaid Fraud Control Unit, and the offices of the Agency for 
272  Health Care Administration Medicaid program integrity program, 
273  and the Divisions of Insurance Fraud and Public Assistance Fraud 
274  within the Department of Financial Services shall, to the extent 
275  possible, be collocated; however, positions dedicated to 
276  Medicaid managed care fraud within the Medicaid Fraud Control 
277  Unit shall be collocated with the Division of Insurance Fraud. 
278  The Agency for Health Care Administration, and the Department of 
279  Legal Affairs, and the Divisions of Insurance Fraud and Public 
280  Assistance Fraud within the Department of Financial Services 
281  shall conduct joint training and other joint activities designed 
282  to increase communication and coordination in recovering 
283  overpayments. 
284         Section 5. Paragraph (o) is added to subsection (2) of 
285  section 20.121, Florida Statutes, to read: 
286         20.121 Department of Financial Services.—There is created a 
287  Department of Financial Services. 
288         (2) DIVISIONS.—The Department of Financial Services shall 
289  consist of the following divisions: 
290         (o) The Division of Public Assistance Fraud. 
291         Section 6. Paragraph (b) of subsection (7) of section 
292  411.01, Florida Statutes, is amended to read: 
293         411.01 School readiness programs; early learning 
294  coalitions.— 
295         (7) PARENTAL CHOICE.— 
296         (b) If it is determined that a provider has provided any 
297  cash to the beneficiary in return for receiving the purchase 
298  order, the early learning coalition or its fiscal agent shall 
299  refer the matter to the Department of Financial Services 
300  pursuant to s. 414.411 Division of Public Assistance Fraud for 
301  investigation. 
302         Section 7. Subsection (2) of section 414.33, Florida 
303  Statutes, is amended to read: 
304         414.33 Violations of food stamp program.— 
305         (2) In addition, the department shall establish procedures 
306  for referring to the Department of Law Enforcement any case that 
307  involves a suspected violation of federal or state law or rules 
308  governing the administration of the food stamp program to the 
309  Department of Financial Services pursuant to s. 414.411. 
310         Section 8. Subsection (9) of section 414.39, Florida 
311  Statutes, is amended to read: 
312         414.39 Fraud.— 
313         (9) All records relating to investigations of public 
314  assistance fraud in the custody of the department and the Agency 
315  for Health Care Administration are available for examination by 
316  the Department of Financial Services Law Enforcement pursuant to 
317  s. 414.411 943.401 and are admissible into evidence in 
318  proceedings brought under this section as business records 
319  within the meaning of s. 90.803(6). 
320         Section 9. Section 943.401, Florida Statutes, is 
321  transferred, renumbered as section 414.411, Florida Statutes, 
322  and amended to read: 
323         414.411 943.401 Public assistance fraud.— 
324         (1)(a) The Department of Financial Services Law Enforcement 
325  shall investigate all public assistance provided to residents of 
326  the state or provided to others by the state. In the course of 
327  such investigation the department of Law Enforcement shall 
328  examine all records, including electronic benefits transfer 
329  records and make inquiry of all persons who may have knowledge 
330  as to any irregularity incidental to the disbursement of public 
331  moneys, food stamps, or other items or benefits authorizations 
332  to recipients. 
333         (b) All public assistance recipients, as a condition 
334  precedent to qualification for public assistance received and as 
335  defined under the provisions of chapter 409, chapter 411, or 
336  this chapter 414, must shall first give in writing, to the 
337  Agency for Health Care Administration, the Department of Health, 
338  the Agency for Workforce Innovation, and the Department of 
339  Children and Family Services, as appropriate, and to the 
340  Department of Financial Services Law Enforcement, consent to 
341  make inquiry of past or present employers and records, financial 
342  or otherwise. 
343         (2) In the conduct of such investigation the Department of 
344  Financial Services Law Enforcement may employ persons having 
345  such qualifications as are useful in the performance of this 
346  duty. 
347         (3) The results of such investigation shall be reported by 
348  the Department of Financial Services Law Enforcement to the 
349  appropriate legislative committees, the Agency for Health Care 
350  Administration, the Department of Health, the Agency for 
351  Workforce Innovation, and the Department of Children and Family 
352  Services, and to such others as the department of Law 
353  Enforcement may determine. 
354         (4) The Department of Health and the Department of Children 
355  and Family Services shall report to the Department of Financial 
356  Services Law Enforcement the final disposition of all cases 
357  wherein action has been taken pursuant to s. 414.39, based upon 
358  information furnished by the Department of Financial Services 
359  Law Enforcement. 
360         (5) All lawful fees and expenses of officers and witnesses, 
361  expenses incident to taking testimony and transcripts of 
362  testimony and proceedings are a proper charge to the Department 
363  of Financial Services Law Enforcement. 
364         (6) The provisions of this section shall be liberally 
365  construed in order to carry out effectively the purposes of this 
366  section in the interest of protecting public moneys and other 
367  public property. 
368         Section 10. Section 409.91212, Florida Statutes, is created 
369  to read: 
370         409.91212 Medicaid managed care fraud.— 
371         (1) Each managed care plan, as defined in s. 409.920(1)(e), 
372  shall adopt an anti-fraud plan addressing the detection and 
373  prevention of overpayments, abuse, and fraud relating to the 
374  provision of and payment for Medicaid services and submit the 
375  plan to the Office of the Inspector General within the agency 
376  for approval. At a minimum, the anti-fraud plan must include: 
377         (a) A written description or chart outlining the 
378  organizational arrangement of the plan’s personnel who are 
379  responsible for the investigation and reporting of possible 
380  overpayment, abuse, or fraud; 
381         (b) A description of the plan’s procedures for detecting 
382  and investigating possible acts of fraud, abuse, and 
383  overpayment; 
384         (c) A description of the plan’s procedures for the 
385  mandatory reporting of possible overpayment, abuse, or fraud to 
386  the Office of the Inspector General within the agency; 
387         (d) A description of the plan’s program and procedures for 
388  educating and training personnel on how to detect and prevent 
389  fraud, abuse, and overpayment; 
390         (e) The name, address, telephone number, e-mail address, 
391  and fax number of the individual responsible for carrying out 
392  the anti-fraud plan; and 
393         (f) A summary of the results of the investigations of 
394  fraud, abuse, or overpayment which were conducted during the 
395  previous year by the managed care organization’s fraud 
396  investigative unit. 
397         (2) A managed care plan that provides Medicaid services 
398  shall: 
399         (a) Establish and maintain a fraud investigative unit to 
400  investigate possible acts of fraud, abuse, and overpayment; or 
401         (b) Contract for the investigation of possible fraudulent 
402  or abusive acts by Medicaid recipients, persons providing 
403  services to Medicaid recipients, or any other persons. 
404         (3) If a managed care plan contracts for the investigation 
405  of fraudulent claims and other types of program abuse by 
406  recipients or service providers, the managed care plan shall 
407  file the following with the Office of the Inspector General 
408  within the agency for approval before the plan executes any 
409  contracts for fraud and abuse prevention and detection: 
410         (a) A copy of the written contract between the plan and the 
411  contracting entity; 
412         (b) The names, addresses, telephone numbers, e-mail 
413  addresses, and fax numbers of the principals of the entity with 
414  which the managed care plan has contracted; and 
415         (c) A description of the qualifications of the principals 
416  of the entity with which the managed care plan has contracted. 
417         (4) On or before September 1 of each year, each managed 
418  care plan shall report to the Office of the Inspector General 
419  within the agency on its experience in implementing an anti 
420  fraud plan, as provided under subsection (1), and, if 
421  applicable, conducting or contracting for investigations of 
422  possible fraudulent or abusive acts as provided under this 
423  section for the prior state fiscal year. The report must 
424  include, at a minimum: 
425         (a) The dollar amount of losses and recoveries attributable 
426  to overpayment, abuse, and fraud. 
427         (b) The number of referrals to the Office of the Inspector 
428  General during the prior year. 
429         (5) If a managed care plan fails to timely submit a final 
430  acceptable anti-fraud plan, fails to timely submit its annual 
431  report, fails to implement its anti-fraud plan or investigative 
432  unit, if applicable, or otherwise refuses to comply with this 
433  section, the agency shall impose: 
434         (a) An administrative fine of $2,000 per calendar day for 
435  failure to submit an acceptable anti-fraud plan or report until 
436  the agency deems the managed care plan or report to be in 
437  compliance; 
438         (b) An administrative fine of not more than $10,000 for 
439  failure by a managed care plan to implement an anti-fraud plan 
440  or investigative unit, as applicable; or 
441         (c) The administrative fines pursuant to paragraphs (a) and 
442  (b). 
443         (6) Each managed care plan shall report all suspected or 
444  confirmed instances of provider or recipient fraud or abuse 
445  within 15 calendar days after detection to the Office of the 
446  Inspector General within the agency. At a minimum the report 
447  must contain the name of the provider or recipient, the Medicaid 
448  billing number or tax identification number, and a description 
449  of the fraudulent or abusive act. The Office of the Inspector 
450  General in the agency shall forward the report of suspected 
451  overpayment, abuse, or fraud to the appropriate investigative 
452  unit, including, but not limited to, the Bureau of Medicaid 
453  program integrity, the Medicaid fraud control unit, the Division 
454  of Public Assistance Fraud, the Division of Insurance Fraud, or 
455  the Department of Law Enforcement. 
456         (a) Failure to timely report shall result in an 
457  administrative fine of $1,000 per calendar day after the 15th 
458  day of detection. 
459         (b) Failure to timely report may result in additional 
460  administrative, civil, or criminal penalties. 
461         (7) The agency may adopt rules to administer this section. 
462         Section 11. Review of the Medicaid fraud and abuse 
463  processes.— 
464         (1) The Auditor General and the Office of Program Policy 
465  Analysis and Government Accountability shall review and evaluate 
466  the Agency for Health Care Administration’s Medicaid fraud and 
467  abuse systems, including the Medicaid program integrity program. 
468  The reviewers may access Medicaid-related information and data 
469  from the Attorney General’s Medicaid Fraud Control Unit, the 
470  Department of Health, the Department of Elderly Affairs, the 
471  Agency for Persons with Disabilities, and the Department of 
472  Children and Family Services, as necessary, to conduct the 
473  review. The review must include, but is not limited to: 
474         (a) An evaluation of current Medicaid policies and the 
475  Medicaid fiscal agent; 
476         (b) An analysis of the Medicaid fraud and abuse prevention 
477  and detection processes, including agency contracts, Medicaid 
478  databases, and internal control risk assessments; 
479         (c) A comprehensive evaluation of the effectiveness of the 
480  current laws, rules, and contractual requirements that govern 
481  Medicaid managed care entities; 
482         (d) An evaluation of the agency’s Medicaid managed care 
483  oversight processes; 
484         (e) Recommendations to improve the Medicaid claims 
485  adjudication process, to increase the overall efficiency of the 
486  Medicaid program, and to reduce Medicaid overpayments; and 
487         (f) Operational and legislative recommendations to improve 
488  the prevention and detection of fraud and abuse in the Medicaid 
489  managed care program. 
490         (2) The Auditor General’s Office and the Office of Program 
491  Policy Analysis and Government Accountability may contract with 
492  technical consultants to assist in the performance of the 
493  review. The Auditor General and the Office of Program Policy 
494  Analysis and Government Accountability shall report to the 
495  President of the Senate, the Speaker of the House of 
496  Representatives, and the Governor by December 1, 2011. 
497         Section 12. Medicaid claims adjudication project.—The 
498  Agency for Health Care Administration shall issue a competitive 
499  procurement pursuant to chapter 287, Florida Statutes, with a 
500  third-party vendor, at no cost to the state, to provide a real 
501  time, front-end database to augment the Medicaid fiscal agent 
502  program edits and claims adjudication process. The vendor shall 
503  provide an interface with the Medicaid fiscal agent to decrease 
504  inaccurate payment to Medicaid providers and improve the overall 
505  efficiency of the Medicaid claims-processing system. 
506         Section 13. All powers, duties, functions, records, 
507  offices, personnel, property, pending issues and existing 
508  contracts, administrative authority, administrative rules, and 
509  unexpended balances of appropriations, allocations, and other 
510  funds relating to public assistance fraud in the Department of 
511  Law Enforcement are transferred by a type two transfer, as 
512  defined in s. 20.06(2), Florida Statutes, to the Division of 
513  Public Assistance Fraud in the Department of Financial Services. 
514         Section 14. Except for sections 10 and 11 of this act and 
515  this section, which shall take effect upon this act becoming a 
516  law, this act shall take effect January 1, 2011.