Curb Medicaid fraud in West Virginia

For years, West Virginia has not done as good a job as many other states in cracking down on Medicaid fraud. It is long past time we changed that.

Medicaid is the single largest program in state government, in terms of cost. About 550,000 West Virginians rely on it for health insurance. Though the overwhelming majority are honest, deserving people, even a tiny percentage of cheats can be quite costly.

Every state has some mechanism for policing Medicaid. Forty-three of the 50 states do the logical thing: They place Medicaid fraud enforcement under their attorneys general.

But for some reason — bureaucratic turf protection, possibly — West Virginia’s program has been under the Department of Health and Human Resources. A bill approved by both chambers of the Legislature, SB 318, would change that. It would put Medicaid fraud control under Attorney General Patrick Morrisey’s office, which has a track record in law enforcement.

In discussing the change with fellow lawmakers last week, Delegate Paul Espinosa, R-Jefferson, noted that under the DHHR, West Virginia has a sub-average rate of catching Medicaid cheats. Because of that, the state “missed out on more than $8 million in a single year,” Espinosa added.

So, the numbers seem clear. But, as so often is the case, politics raised its ugly head in the debate over SB 318. It passed the state Senate in a bipartisan, 26-8 vote. But in the House, the 58-42 tally was along party lines.

This isn’t political. It is about saving money for the Medicaid program — funds that can stay in taxpayers’ pockets or, perhaps, do more for West Virginians who need health care help.

Legislators have sent the bill to Gov. Jim Justice. He should sign it into law without delay.

The sooner Morrisey’s office can get up and running with a more effective Medicaid fraud unit, the better.


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