A task force appointed by the governor is recommending a more than 60 percent increase in the number of state employees who investigate Medicaid fraud allegations. The group also recommends using better technology, including artificial intelligence, to detect fraud patterns in the bills health care providers submit for Medicaid reimbursement. Iowa Attorney General Brenna Bird was the task force chair.
Governor Reynolds issued an executive order in July, directing the task force to come up with a list of ideas by the end of October. The group says services like in-home care visits should be electronically verified. Iowa Solicitor General Eric Wesson helped write the report, which will be submitted to the governor before it is released to the public.
Attorney General Bird says Medicaid fraud should become a felony — just like private insurance fraud — and payments to health care providers that are credibly accused of fraud should be immediately suspended during an investigation.
Critics say these proposals could and should have been implemented years ago. Kevin Techau (TECK-ah) led the state agency that investigated Medicaid fraud from 1999 to 2003, when Democrat Tom Vilsack was governor.
The federal government pays 75 percent of the salaries for the state employees who investigate Medicaid fraud allegations. And Techau faults Governor Reynolds for putting a representative of the managed care industry on the task force and for not including the state auditor’s office, which is led by Rod Sand, the Democratic candidate for governor.
Techau said. Some of the task force recommendations can be implemented before Governor Reynolds leaves office, but other ideas like hiring more state employees and increasing the penalty for Medicaid fraud must be approved by the Iowa legislature and Iowa’s next governor in 2027.
