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Hawaii AG Joins in Call for Expansion of Medicaid Fraud Authority

Attorney General Doug Chin yesterday joined the attorneys general of 37 states and the District of Columbia urging the federal government to change its policy so state attorneys general can use federal funds to investigate and prosecute a wider range of Medicaid abuse and neglect cases.

The letter was sent to Tom Price, Secretary of Health and Human Services, by the National Association of Attorneys General (NAAG).

Click to read letter

Medicaid is a joint federal-state program that provides free or low-cost medical benefits to millions of Americans. More than 6.4 million people enrolled in the Medicaid program are age 65 or older. According to the Centers for Disease Control and Prevention, 1 in 10 persons age 65 and older who live at home will become a victim of abuse.

Attorney General Chin said, “The Hawaii Medicaid Fraud Control Unit receives thousands of complaints relating to fraud and abuse and neglect every year. We will continue to vigorously investigate and prosecute these cases. We hope that the federal government will hear our concerns and support our efforts to protect Hawaii’s most vulnerable residents.”

Medicaid Fraud Control Units (MFCUs) investigate and prosecute state Medicaid provider fraud and resident abuse and neglect complaints in board and care facilities. In Hawaii, MFCU operates in the Department of the Attorney General.

According to the bipartisan letter signed by Attorney General Chin:

“[T]he current strict federal limitations on states’ ability to use MFCU assets to investigate abuse and neglect are outdated, arbitrarily restrict our ability to protect Medicaid beneficiaries from abuse and neglect as Congress intended, and should be replaced or eliminated.

We respectfully request you take swift action to eliminate federal regulations that needlessly narrow our use of these valuable assets. Instead, we request to be freed to use federal MFCU funds to detect, investigate and prosecute abuse and neglect committed against Medicaid beneficiaries or in connection with Medicaid-funded services to the fullest extent permitted by federal statute.”

The letter from NAAG offered two specific recommendations:

  • Allow MFCU federals funds to be used to investigate and prosecute abuse and neglect of Medicaid beneficiaries in non-institutional settings (i.e. home health care).
  • Allow use of MFCU federal funds to freely screen or review any and all complaints or reports of whatever type, in whatever setting.

A copy of the letter is attached.

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