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W. Va. Senate to vote on Medicaid fraud bill


The Intelligencer of Wheeling
WHEELING, W.Va.  — It’s estimated 5 to 20 cents of every $1 paid out in Medicaid funds is spent on wasteful claims, which could mean West Virginia is losing as much as $100 million a year due to Medicaid fraud, according to information provided by the West Virginia Attorney General’s Office.

Now the power to investigate reports of Medicaid abuse could go to the attorney general’s office under a bill before the state Legislature.

Senate Bill 500 is expected to have its third reading and be voted on today in the Senate. The measure would transfer the power to investigate Medicaid claims from the Medicaid Fraud Control Unit under the Department of Health and Human Resources to the office of the attorney general.

Attorneys general oversee Medicaid fraud investigations in 43 of the 50 states, according to West Virginia Attorney General Patrick Morrisey.

He said even by conservative estimates, West Virginia’s Medicaid program may be losing $100 million annually due to fraud. The DHHR’s Medicaid Fraud Control Unit has reported recovering just $40 million during the past two years, according to Morrisey.

“This means that we’re leaving a lot of money on the table,” he said.

Sen. Ryan Weld, D-Brooke, said lawmakers have become increasingly aware in recent years that the amount of Medicaid fraud recovery in West Virginia isn’t at the level it should be. They then consulted with Morrisey on how to improve the state’s methods.

“Over the past few years, we’ve seen we haven’t been doing as well in investigations as we could have been doing. When we took a look at the options, we saw a lot of states put Medicaid investigations under their attorney general,” Weld said. “We had talks with Morrisey on how to bring investigations to his office. He had ideas on how to improve the system, and thought it might be a good idea for the attorney general to improve investigations. We had to get together to find a way.”

And Morrisey’s office reports it has had success investigating disability fraud within the Social Security system.

Its Cooperative Disability Investigations Unit, in partnership with the Social Security Administration, has generated $2.5 million in projected savings for state and federal governments during its first year of operation, according to data provided by the office.

If passed by the Senate today, SB 500 will move on to the House of Delegates.

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