CHARLESTON, W.Va. — State Attorney General Patrick Morrisey is continuing his call for state lawmakers to move the state’s Medicaid Fraud Control Unit from under the state Department of Health and Human Resources to his office.
Morrisey repeated the request during his office’s budget hearing before the House of Delegates Finance Committee late last week.
“I’m hopeful this is the year that folks take advantage of the savings opportunities and the quality you can bring to bare if you move that division and you are consistent with what 43 other states do,” Morrisey said.
The fraud unit is currently under the DHHR’s Office of Inspector General. That office’s web page said the unit “is the single entity of West Virginia state government that is certified annually by the Secretary of the U.S. Department of Health and Human Services to conduct statewide investigations of health care providers that defraud the Medicaid program.”
Mike Malone recently took over as director. The MFCU currently employs eight investigators, two auditors and one data mining specialist. It has an annual budget of $1.88 million incuding the 75 percent federal match. The unit currently has 25 positions in the federal grant.
Morrisey said West Virginia is currently an outlier by not having the fraud unit with the attorney general’s office but it shouldn’t be.
“West Virginia should save more money and the money that is saved the beneficiaries. the taxpayers, should save from that,” he said. “This is the second largest program in West Virginia. This is about budget savings and I think it could be very beneficial.”
Total federal and state Medicaid spending in West Virginia is more than $3.7 billion. It is second only to education in annual state funding. Medicaid funds are distributed through the DHHR. Morrisey said the agency handling the money shouldn’t be the agency investigating possible fraud.
“If one department is going to be spending such a significant portion of the state budget, it certainly makes a lot of sense to have a completely separate entity take a look at that and analyze the expenditures. I think that alone, a fresh pair of eyes on a variety of issues, could result in savings,” Morrisey said.
Del. Paul Espinosa, R-Jefferson, agreed.
“Just because of the size of the budget, it just makes sense to provide some additional scrutiny there, just to make sure those dollars are being spent wisely,” Espinosa said.
Morrisey added his office could also form stronger partnerships with AG offices in other states that operate Medicaid fraud units.
“I think we can leverage the relationships a little bit better and that can result in more resources. Second, there are certain tools you can put in place to be more aggressive,” he said.
The DHHR did not respond to a request for comment for this story.