Rutledge Seeks Expansion of Medicaid Fraud Authority to Investigate Resident Abuse
May 10, 2017
Joins 37 other attorneys general in letter to Health of Human Services Secretary
LITTLE ROCK – Arkansas Attorney General Leslie Rutledge has sent a letter today urging Secretary of Health and Human Services Tom Price to grant greater authority to State attorneys general, allowing them to use federal funds to prosecute and investigate a wider range of Medicaid abuse and neglect cases, including those that happen in homes.
“Regulations have restricted the use of federal funds in ways that hamper my ability to thoroughly investigate and prosecute abuse and neglect of Medicaid beneficiaries to the fullest extent of the law,” said Attorney General Rutledge. “No one should live through mistreatment, and I am committed as the State’s top law enforcement officer to holding individuals accountable whether that abuse takes place in an institution or non-institutional setting.”
In the letter, signed by 38 attorneys general, Rutledge and her colleagues write, “The current strict federal limitations on states’ ability to use MFCU assets to investigate abuse and neglect are outdated, arbitrarily restrict our ability to protect Medicaid beneficiaries from abuse and neglect as Congress intended and should be replaced or eliminated.”
The letter calls on Secretary Price to allow MFCU federal funds to be used to investigate and prosecute abuse and neglect of Medicaid beneficiaries in non-institutional settings and to allow funds to freely screen or review any and all complaints or reports of whatever type, in whatever setting.
Led by attorneys general from Connecticut and Kansas, Rutledge is joined on the letter by attorneys general from Alaska, Arizona, Colorado, District of Columbia, Hawaii, Indiana, Iowa, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, West Virginia, Wisconsin and Wyoming.
In January, Rutledge announced that the MFCU had obtained more Medicaid fraud convictions and opened more criminal investigations in 2016 than ever before. In 2015, the MFCU set a record with 14 Medicaid fraud convictions and 108 opened criminal investigations. In 2016, Medicaid fraud convictions increased to 17 and the MFCU opened a record 112 criminal investigations, which brought the total Medicaid fraud convictions during the Rutledge administration to 31 in 24 months.
Medicaid fraud occurs when providers use the Medicaid program to obtain money to which they are not entitled. There are times that Medicaid residents, especially the elderly, are physically and sexually abused or neglected by health care workers. Physical abuse or neglect includes anything from striking to sexually assaulting a resident to withholding necessary and adequate food, physical care or medical attention. Financial abuse includes the misuse of a resident’s trust funds to pay for nursing home services already being paid for by the Medicaid program or for uses of a resident’s funds not authorized by the resident or the resident’s guardian, trustee or administrator.
To report Medicaid fraud or abuse or neglect in residential care facilities, submit a confidential online form or contact the Attorney General’s Medicaid fraud hotline at (866) 810-0016 or firstname.lastname@example.org.