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Medicaid fraud convictions top last year, attorney general says

  

JEFFERSON CITY, Mo. — As Missouri lawmakers continue looking into why a large amount of children have been suddenly and recently dropped from the state’s Medicaid program, Attorney General Eric Schmitt said his office has already brought in more restitution and convictions of Medicaid fraud from last year. 

The Attorney General’s Office said its Medicaid Fraud Control Unit’s investigations have resulted in 19 convictions and more than $5 million in restitution since January. Last year alone, the office secured seven convictions and $3.1 million from cases of Medicaid fraud. 

“Our Medicaid Fraud Control Unit works tirelessly to investigate and prosecute instances of fraud within the Medicaid system in Missouri, ensuring that the Attorney General’s Office serves as a fearless advocate for our most vulnerable citizens,” Schmitt said in a statement. 

“These figures send a clear message to anyone who wishes to use the Medicaid system for unlawful [personal] gain: We will hold you accountable for your actions.” 

Missouri lawmakers have been at loggerheads over the cause — and potential fix — of the considerable reduction in enrollment of children in MO HealthNet, the state’s Medicaid program, over the past 18 months. 

In July, 7,8000 individuals — of which more than 6,000 are children — had state health care rescinded, according to the Missouri Department of Social Services (DSS) data. In total, about 128,000 people — of which 101,000 are children — have been removed from MO HealthNet rolls since January 2018. 

House Speaker Elijah Haahr has pointed to changes to the federal Affordable Care Act, an improved economy, new technology, and a failure of the previous gubernatorial administration to properly verify MO HealthNet eligibility for the decline in enrollment. Democrats, however, are not as convinced. 

House Minority Leader Crystal Quade has asked for a special House committee to be convened to investigate. She’s also criticized Gov. Mike Parson’s call for a special session to address a vehicle sales tax issue amid the Medicaid issue. 

As for potential Medicaid fraud, the Attorney General’s Office has encouraged Missourians to report suspected wrongdoings by calling 800-286-3932 or by filling out a form at http://ago.mo.gov/criminal-division/medicaid-fraud.

Alisha Shurr contributed to this report.