AG Brnovich Calls for Expanded Medicaid Fraud Authority to Prosecute More Senior Abuse Cases

PHOENIX – Attorney General Mark Brnovich is urging the federal government to change its policy to allow state attorneys general to use federal funds to investigate and prosecute in-home Medicaid abuse and neglect cases involving seniors. Brnovich joined 36 other state attorneys general and the District of Columbia in signing the bi-partisan letter calling for expanded medicaid fraud authority.

“The statistics are alarming, 1 in 10 persons age 65 and older who live at home will become a victim of abuse,” said Attorney General Mark Brnovich. “We need to do everything in our power to protect all Arizona seniors from abuse and neglect including those who are under in-home care services.”

Medicaid Fraud Control Units (MFCUs) investigate and prosecute state Medicaid provider fraud and resident abuse complaints in Medicaid-funded health care facilities. In most states, MFCUs operate in the state attorney general’s office. The Social Security Act expressly allows use of MFCUs to investigate and prosecute patient abuse/neglect in “health care facilities” or “board and care facilities,” but the statute does not prohibit use of federal MFCU funds to investigate abuse/neglect in non-institutional settings. This regulatory restriction arbitrarily limits the scope of potential abuse or neglect cases MFCUs can investigate or prosecute. More than 6.4 million people enrolled in the Medicaid program are age 65 or older.

The letter offers two recommendations:

  • Allow MFCU federals funds to be used to investigate and prosecute abuse and neglect of Medicaid beneficiaries in non-institutional settings (i.e. home health care).
  • Allow use of MFCU federal funds to freely screen or review any and all complaints or reports of whatever type, in whatever setting.

The letter was sent to the U.S. Department of Health and Human Services Secretary Tom Price.

Full copy of the letter.