- Associated Press - Friday, November 18, 2016

MORGANTOWN, W.Va. (AP) - West Virginia’s newly re-elected Attorney General Patrick Morrisey plans to target Medicaid fraud in his second term and ask the Legislature to give his office more authority to crack down.

Morrisey, who promises this will be his last term as the state’s top lawyer, cites success investigating fraudulent disability claims, saying it has saved $1.4 million so far working with the Social Security Administration.

In continuing to push for Medicaid oversight, which he first proposed almost two years ago, he said the state could save millions of dollars in the federal- and state-funded health care program for the poor. Under current law, the state’s Medicaid fraud control unit is housed within the Department of Health and Human Resources.

“My hope is we can build on the success of disability fraud, do a lot more on Medicaid fraud and then ideally expand to other areas of state government,” Morrisey said. “Because I believe in this state there’s a lot of waste in state government.”

When he first asked legislators for almost $350,000 to add three attorneys to help clear cases, including suspicious billing and payments, he predicted they would save West Virginia more than that.

The state’s recently expanded Medicaid program serves about 542,000 people, according to state health officials. It cost $4.1 billion in the latest fiscal year, with the federal government paying 71 percent for those originally covered and all costs in the expansion. Most people have been moved into managed care programs.

The current fraud unit reports referring 24 cases for prosecution, with 10 criminal convictions, 22 civil cases resolved and $5.3 million recovered last year. Its 2014 investigation of an out-of-state laboratory resulted in a record $4.7 million settlement working with federal prosecutors and health authorities, department spokeswoman Allison Adler said.

The attorney general’s office recently added a criminal investigations component looking for Social Security disability fraud. Two investigators and an analyst had already been reviewing suspicious disability claims.

Morrisey said they helped administratively prevent more than $1.4 million in improper payments over nine months. They are now also reviewing past claims and payments for fraud and possible referral to county and federal prosecutors.

The Republican is returning to office after getting 52 percent of the vote in a race against Democrat, state legislator and businessman Doug Reynolds, who got 42 percent. The attorney general, with a staff of 188 including 95 attorneys, also defends the state in lawsuits.

He promises ongoing efforts to reduce prescription drug abuse that has plagued West Virginia, which recorded 686 drug overdose deaths last year - 598 from opioids. One key approach should be financial incentives for prescribing non-opiate painkillers, which would require “a cultural shift” in both the government and business, he said.

In cases the office inherited from previous Attorney General Darrell McGraw, nine pharmaceutical companies have reached settlements to pay more than $7.5 million to the state settling allegations that they failed to detect, report and stop suspiciously large drug orders in West Virginia. Other cases are pending. Morrisey, married to a Washington lobbyist who did work for Cardinal Health, recused himself from the cases.

Some of his deputies have been cross-designated as federal prosecutors to focus on cases against street drug dealers in the northern half of the state with five convictions so far, he said. The office has joined 42 state attorneys general suing the makers of Suboxone used to treat opioid addiction, alleging the companies engaged in a scheme to block generic drugs by competitors.

This summer, Morrissey called for best practices by doctors and pharmacists to regularly monitor patients’ opioid use, conduct physicals and urine tests to spot misuse, educate them about risks and approve prescriptions after screening and considering non-opioid alternatives. West Virginia associations of doctors and other health care providers have endorsed the practices.

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This story has been corrected to show that Morrisey first proposed his office take on more Medicaid oversight two years ago, not a year ago.


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