Fraud prevention & reform

As the need for substance abuse and mental health treatment escalates, it is incumbent upon the state to ensure that limited dollars are being used appropriately and those seeking help are actually receiving it.

SB 123 and HB 259 will go a long way in helping to detect and weed out fraud and abuse surrounding these types of facilities. Those seeking services, as well as those paying for services, will have greater assurance that suitable treatments are being administered, and in an appropriate manner.

 

SB 123 permits a local government to request that the Office of Licensing for the Department of Human Services notify that local government of any new human services program license applications within their local jurisdiction. In doing this, a local governmental entity will be more aware of the programs administered within their community and thus, better able to monitor where necessary.

 

HB 259 requires that rules be made to define what constitutes an outpatient treatment program and to develop minimum standards for licensed providers of substance abuse and mental health services. In order to address existing problems, the bill also requires the establishment of a procedure for insurer access to licensee records regarding services or supplies billed to the insurer, and to set in place procedures for the investigation and processing of complaints against licensees.