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Capitol Correspondence - 04.01.18

Bill to Clarify Role of Medicaid Fraud Control Units Gains Traction among State AGs

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A bill in the U.S. House of Representatives introduced in September 2017 is gaining attention nationwide. Sponsored by U.S. Representative Tim Murphy (R-MI), H.R. 3891 is titled “To amend title XIX of the Social Security Act to clarify the authority of State Medicaid fraud and abuse control units to investigate and prosecute cases of Medicaid patient abuse and neglect in any setting, and for other purposes.”

The goal of the bill is to expand the authority of state Medicaid Fraud Control Units (MFCUs) beyond existing law. Currently, MFCUs are mostly limited to health care facilities. HR 3891 would change this by expanding the scope of MFCUs’ authority to non-institutional settings.

49 State Attorney Generals have signed onto a letter supporting this bill, stating: “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.”

ANCOR is currently researching and analyzing this bill and will report back to ANCOR members once this process is complete.