TOPEKA – Kansas Attorney General Derek Schmidt today led a bipartisan group of 49 state and territorial attorneys general in asking Congress to ease federal restrictions that limit states’ ability to investigate and prosecute the abuse and neglect of Medicaid beneficiaries.
Schmidt and his colleagues in a letter to U.S. Representatives Tim Walberg, R-Mich., and Peter Welch, D-Vt., offered support for a bill sponsored by Walberg and Welch, which would expand the authority of Medicaid Fraud Control Units (MFCUs) to detect, investigate and prosecute Medicaid patient abuse in non-institutional settings.
The legislation, H.R. 3891, was introduced after a similar group of 38 attorneys general wrote to then-U.S. Secretary of Health and Human Services Tom Price in May 2017, asking for changes in federal regulation to give the states this expanded authority. However, the Department concluded that the expanded authority would require a change in federal law that could not be done through the regulatory process. The bill, introduced by Walberg and Welch, was in direct response to the attorneys general’s letter and subsequent response from the Department.
“This change is vitally important because it eliminates the blinders current law places on MFCUs’ ability to detect, investigate and prosecute cases of abuse or neglect of Medicaid patients,” the attorneys general wrote. “Since the current statute was enacted decades ago, substantial growth has occurred in home and community-based services, office-based services, transportation services, and other settings that are neither ‘health care facilities’ nor ‘board and care facilities’ but where services are provided and thus patient abuse or neglect may occur. H.R. 3891 proposes a common-sense change that will better protect an often-vulnerable population and will maximize the benefits and efficient use of MFCU assets.”
If enacted, the legislation would allow state MFCUs, most of which are housed within state attorney general’s offices, to investigate and prosecute abuse and neglect of Medicaid beneficiaries in non-institutional settings and broaden their authority to screen complaints or reports alleging potential abuse or neglect. Under current law, MFCUs may investigate and prosecute patient abuse and neglect only if it occurs in a health care facility or, in some circumstances, in a board and care facility. That means other cases of abuse and neglect of Medicaid patients – such as in a home health care setting – fall outside the unit’s authority.
The attorneys general also stressed to the lawmakers the importance of expanding this authority in light of the national opioid epidemic. The bill would, for example, give states the authority to investigate and prosecute cases of unlawful opioid distribution to Medicaid beneficiaries, which under current law they may only do if the case occurred within a health care facility or a board and care facility.
The effort was led by Schmidt, George Jepsen, D-Conn., Mike Hunter, R-Okla., and T.J. Donovan, D-Vt. Other attorneys general who signed the letter were Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Virgin Islands, Virginia, Washington, West Virginia, Wisconsin and Wyoming.
A copy of the letter is available by clicking here.