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March 28, 2018

Attorney General Tom Miller asks Congress to improve states' ability to combat abuse of Medicaid patients

Legislation is critical to fight national opioid epidemic

(DES MOINES, Iowa)  Attorney General Tom Miller, along with a bipartisan group of 48 other state and territory attorneys general, asked Congress to ease federal restrictions that limit states’ ability to investigate and prosecute the abuse and neglect of Medicaid beneficiaries.

The attorneys general sent a letter today to U.S. Reps. Tim Walberg, R-Mich., and Peter Welch, D-Vt., in support of their legislation, H.R. 3891. The bill would expand the authority of Medicaid Fraud Control Units (MFCUs) to detect, investigate and prosecute Medicaid patient abuse in home health care and other non-institutional settings.

The attorneys general also stressed to the lawmakers the importance of expanding this authority in light of the national opioid epidemic. For example, the bill would 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.

“We should be able to investigate abuse in a home- or community-based setting, particularly when it comes to opioid cases,” Miller said.

The legislation came 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.

If enacted, the legislation would allow state MFCUs 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.

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