State authority to fight abuse of Medicaid patients has been expanded by Congress

FILE - (AP Photo/J. Scott Applewhite, File)
FILE - (AP Photo/J. Scott Applewhite, File)(KY3)
Published: Dec. 24, 2020 at 11:53 AM CST
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TOPEKA, Kan. (WIBW) - Congress has expanded state authority to fight the abuse of Medicaid patients.

Attorney General Derek Schmidt says new federal legislation that broadens state authority to fight the abuse of Medicaid patients is awaiting President Trump’s signature.

According to Schmidt, the measure was introduced as the Medicaid Patient Abuse Prevention Act and was included as part of the appropriations and COVID-19 relief legislation that Congress approved on Monday. He said the legislation is currently awaiting the signature of the President.

Schmidt said he has advocated for passage of the anti-abuse law since 2017 when he was the incoming president of the National Association of Attorneys General, and most recently in April led a bipartisan group of attorneys general in advocating for the inclusion of the bill in COVID-response legislation because isolation caused by COVID-19 has increased the risk that abuse of patents in home health settings may go unnoticed or unprosecuted.

“I am grateful that Congress has given states this additional authority to investigate and, when appropriate, prosecute cases in which Medicaid patients are criminally abused in home health care and other non-institutional settings,” Schmidt said. “This expanded jurisdiction will give us greater ability to bring to justice those who harm elder and disabled Kansans. I particularly want to thank Senator Moran and Senator Roberts, who both co-sponsored this bill and worked for its inclusion in the appropriations measure that now has passed.”

According to Schmidt, the bill will allow state Medicaid Fraud Control Units to fight the abuse of Medicaid patients anywhere that abuse occurs. He said under current laws, states may use MFCUs to detect, investigate and prosecute patient abuse only if it happens in an institutional setting like a nursing home or hospital. He said abuse of patients in non-institutional settings, like during home health care, was outside of MCFU jurisdiction. He said the new law eliminates that limit.

Schmidt said around three years ago he began to lead a national effort to urge Congress to broaden the jurisdiction of MFCUs in order for states to strengthen the fight against patient abuse. He said in 2018, he testified in support of the legislation before a subcommittee of the U.S. House of Representatives Committee on Energy and Commerce, and in 2019 he again testified for it before the U.S. Senate Special Committee on Aging. He said in July, he testified in favor of the legislation a third time before the Senate Committee on Commerce, Science and Transportation Subcommittee on Manufacturing, Trade and Consumer Protection. He said Sen. Moran, chair of the subcommittee, invited him to testify as part of a discussion of efforts by state attorneys general to fight scams and fraud during the COVID-19 pandemic.

According to Schmidt, as a condition of participation in the Medicaid program, states usually are required to operate an MFCU to help find, investigate and prosecute Medicaid provider fraud and patient abuse. He said in Kansas, as in most states, the unit is housed in the attorney general’s office. He said the federal government pays three-fourths of the cost of operating the units and because of this, sets limits on their jurisdiction. He said one of those limits has prevented states from using the units to address patient abuse in non-institutional settings like a home health care situation.

Schmidt said in addition to expanding MFCU jurisdiction, Congress also voted to extend the deadline for the CARES Act funding and to provide additional federal funding for the expansion of the national broadband system. He said he joined bipartisan efforts in recent months that encouraged Congress to act favorably on both measures.

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