ATTORNEY GENERAL BRENNA BIRD HOLDS LAST MEDICAID FRAUD ELIMINATION TASK FORCE MEETING, MAKES RECOMMENDATIONS TO GOVERNOR

The following information was released by the office of the Iowa Attorney General:

Attorney General Brenna Bird announced the final Medicaid Fraud Elimination Task Force meeting was held today. At the end of today's meeting, the Task Force voted to send its recommendations to Governor Kim Reynolds. The Governor will publicly release the final report once she has reviewed it.

Ahead of a final report, the Task Force released an executive summary of their recommendations. Here are the highlights:

Stop paying fraudsters, fast. The Task Force recommends standing up a Medicaid Fraud War Room, based on the federal Centers for Medicare and Medicaid (CMS) model, so when there is a credible allegation of fraud, Iowa can suspend payments to the provider within 24 hours while investigators build the case and refer the provider for a nationwide ban from federal health programs within five business days

Put more investigators and prosecutors on the case. Iowa's fraud unit already brings more criminal cases per employee than any unit in the country, but it has just nine people policing an $8.7 billion program. The Task Force recommends growing it to 24.

Tougher criminal sentences for stealing from Medicaid. The Task Force recommends making Medicaid fraud a felony on the same level as insurance fraud, with a higher sentence for thefts over $10,000.

Make sure every provider is real. The Task Force recommends that Iowa Medicaid revalidate high-risk providers, deactivate providers who are not actually serving patients, use secret shoppers and data checks to confirm that providers listed in managed care networks are real and available, and modernize network standards last updated in 2016.

Protect the most vulnerable. Fraud concentrates in high-risk services such as in-home care. The Task Force recommends using data to target reviews where risk is highest and strengthening electronic visit verification, which confirms that a caregiver actually showed up before taxpayers pay for the visit

Empower every Iowan with a way to report fraud. The Task Force recommends that state agencies work together to clearly explain what Medicaid fraud is and how to report it, coordinate messaging across state agencies, promote IowaFraudFighters.gov, and release a plain-language video on spotting and reporting fraud.

"I've said all along, no amount of Medicaid Fraud is acceptable because Iowans don't get services they need and taxpayers are getting ripped off," said Attorney General Bird. "The Task Force has recognized ways we can do better to prevent fraud. We need to proactively root it out and make the fraudsters pay for their crimes. Our recommendations will help the Iowans who need Medicaid and protect the hard-working Iowans who pay for it."