March 28, 2018
Carson City, NV – Today, Nevada Attorney General Adam Paul Laxalt and a bipartisan coalition of 48 other states and territorial attorneys general sent a letter asking Congress to ease federal restrictions that limit states’ ability to investigate and prosecute the abuse and neglect of Medicaid beneficiaries. The letter supports House Resolution (HR) 3891, which would expand the authority of Medicaid Fraud Control Units (MFCUs) to detect, investigate and prosecute Medicaid patient abuse in non-institutional settings.
This legislation was introduced after a similar group of 38 attorneys general wrote a letter 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. Nevada also signed on to that bipartisan letter. The Department concluded that the expanded authority would require a change in federal law that could not be made through the regulatory process. HR 3891 was drafted in direct response to the attorneys general’s letter and subsequent response from the Department.
If enacted, the legislation would allow state MFCUs, most of which, like Nevada’s, 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.
“My Medicaid Fraud Control Unit works hard to protect Medicaid patients by investigating and prosecuting Medicaid providers who commit financial fraud,” said Laxalt. “This letter supports Congress’ proposed legislation that would provide our Medicaid Fraud Control Unit with important additional tools to combat the opioid crisis and fight against abuse and neglect of all Medicaid patients.”
The coalition of 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.
In addition to Nevada, other states and territories that participated in the letter include: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virgin Islands, Virginia, Washington, West Virginia, Wisconsin and Wyoming.
To view the issued letter, click here.