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Attorney General Jason R. Ravnsborg

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AG Jackley asks Congress to Improve States’ Ability to Combat Abuse and Neglect of Medicaid Patients

PIERRE, S.D.- Attorney General Marty Jackley joined a bipartisan group of 48 other state and territory Attorneys General today and asked Congress to ease federal restrictions that limit states’ ability to investigate and prosecute the abuse and neglect of Medicaid beneficiaries.

"It is important that we protect against neglect and abuse," Jackley said. “We are fortunate that the vast majority of caregivers in South Dakota provide high quality health care, and we will continue to work with our partners and our caregivers to ensure that our citizens receive the highest level of care in both home and facility settings."

The coalition of Attorneys General today sent a letter to U.S. Representatives Tim Walberg, R-Mich., and Peter Welch, D-Vt., in support of their legislation, H.R. 3891, which would expand the authority of Medicaid Fraud Control Units (MFCUs) to detect, investigate and prosecute Medicaid patient abuse in non-institutional settings.

The legislation came after a similar group of 38 Attorneys General wrote to then-U.S. Secretary of Health and Human Services Tom Price in May 2017, asking for changes in federal regulations to give the states this expanded authority. However, the Department concluded that the expanded authority would require a change in federal law that could not be done through the regulatory process. The bill, introduced by Walberg and Welch, was in direct response to the letter from the Attorneys General and subsequent response from the Department.

If enacted, the legislation would allow state MFCUs, most of which are housed within state Attorney General’s offices, to investigate and prosecute abuse and neglect of Medicaid beneficiaries in non-institutional settings and broaden their authority to screen complaints or reports alleging potential abuse or neglect. 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. That means other cases of abuse and neglect of Medicaid patients – such as in a home health care setting – fall outside the unit’s authority.

The Attorneys General also stressed to the lawmakers the importance of expanding this authority in light of the national opioid epidemic. The bill would, for example, give states the authority to investigate and prosecute cases of unlawful opioid distribution to Medicaid beneficiaries, which under current law they may only do if the case occurred within a health care facility or a board and care facility.