Ohio joins other states in Medicaid suit

Submitted information

COLUMBUS — Ohio Attorney General Mike DeWine, along with a bipartisan coalition of 48 other state attorneys general and the National Association of Attorneys General, has expressed support for a bill that would ease federal restrictions that limit states’ ability to investigate and prosecute the abuse and neglect of Medicaid beneficiaries.

“This change is vitally important because it eliminates the blinders current law places on Medicaid Fraud Control Units’ ability to detect, investigate, and prosecute cases of abuse and neglect of Medicaid patients,” wrote Attorney General DeWine and the other attorneys general in their letter. “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 or board and care facilities.”

The bill, H.R. 3891, introduced by U.S. Representatives Tim Walberg (R-Michigan) and Peter Welch (D-Vermont), would expand the authority of state Medicaid Fraud Control Units (MCFUs), most of which are housed within state attorney general offices, to detect, investigate, and prosecute Medicaid patient abuse in non-institutional settings.

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. This means other cases of abuse and neglect of Medicaid patients — such as in a home health care setting — currently fall outside the unit’s authority.

The attorneys general also stressed the importance of expanding this authority in light of the national opioid epidemic.

“Consider, for example, a situation in which a Medicaid beneficiary in a home or community-based setting is provided prescription opioid painkillers in an unlawful manner, resulting in death or great bodily harm to the patient,” the attorneys general added in the letter. “Under current law, although the patient harm caused by the distribution of those opioids may have been criminal, our MFCUs would be hampered or prevented from investigating or prosecuting the case of patient abuse because it occurred in a setting other than a health care facility or board and care facility.”

A copy of the letter of support sent to the bill’s sponsors is available on the Ohio Attorney General’s website at www.OhioAttorneyGeneral.gov.