CHARELSTON, W.Va. –Assistant State Attorney General Lauren Plymale recently traveled to Washington, D.C., to provide input to the White House Task Force to Eliminate Fraud on combating fraud across government programs.
The meeting, held May 26, brought together attorney generals from across the U.S. for a roundtable led by Vice President JD Vance at the Eisenhower Executive Office Building. The White House task force was created by President Donald Trump in March to help combat fraud, waste, and abuse.
Vance, in his opening remarks at the roundtable, told the attorney generals that in only two months, they had identified billions of dollars in benefits stolen from the American people.
Plymale, who also serves as director of the Attorney General’s Medicaid Fraud Control Unit, appeared on MetroNews Midday the Wednesday following the meeting.
She said West Virginia is working to create a data-driven system that uses both traditional methods and advanced analytical tools to assist with fraud investigations.
“It will improve efficiency in our cases and ensure that our investigative resources are actually directed where they can have the greatest impact,” Plymale said. “And we’re adding an AI (artificial intelligence) component that is going to be prompt driven to help generate structure and to increase the length of time these complex cases usually require.”
She said that because West Virginia is known as an epicenter of drug addiction, the state sees significant issues involving the human trafficking of recovery residents and patient brokering. Plymale also said the state has seen problems involving Peer Recovery Support Services, in which individuals assist people with substance use disorder in obtaining treatment and recovery services.
However, she said the state still sees cases of financial exploitation as well, particularly in the Medicaid program.
“A lot of what we receive is abuse and neglect and financial exploitation and what we’re trying to do is make sure we look at all aspects of that to make sure that if Medicaid dollars are being spent we attack that from both the abuse and neglect as well as the fraud aspect,” Plymale said.
She said another effort involves working with state and federal agencies to trace the origins of organizations under investigation and determine where the money is going because officials do not want to see West Virginia tax dollars sent overseas.
“Make sure that they came to the state of West Virginia and that we can try and put the roadblocks up to try by working with other agencies to make sure that we can prohibit that in the future but that is a more of a collaborative effort because the data exists in other places,” Plymale said.
She said these remain difficult tasks but necessary ones.
“The best way to protect the integrity of the Medicaid system is to make sure that those providers who are actually doing what they need to do, being able to protect them as well as preserves the programs integrity, so holding wrong doers accountable strengthens the Medicaid system and we want to send a clear message that fraud will not be tolerated in West Virginia,” Plymale said.