Attorney General's News Release

January 11, 2006

Nixon provides General Assembly with specific proposals to fight Medicaid fraud by providers

Jefferson City, Mo. — Attorney General Jay Nixon today provided members of the Missouri General Assembly with six specific proposals to help the state fight fraud by Medicaid providers. Nixon’s proposals come as a special committee of the Missouri Senate investigates such fraud. A letter containing the proposals and a more detailed outline of the proposals were delivered yesterday to the committee members.

The proposals from Nixon are for the General Assembly in 2006 to pass legislation to:

• Create a State False Claims Act for Medicaid fraud.
• Require pharmaceutical companies to disclose and certify, under penalty of perjury, their Average Manufacturer’s Price and Average Sales Price to the Division of Medical Services on a monthly basis.
• Impose criminal sanctions for providers who obstruct an investigation.
• Provide enhanced investigative tools to uncover fraud.
• Expand the definition of “abuse” of a nursing home resident to include financial abuse.
• Eliminate the loophole that allows nursing home operators to avoid civil penalties when they commit violations impacting patient health or safety.

After taking office in 1993, Nixon established a Medicaid Fraud Control Unit within his office. At the time, Missouri was one of only a few states without such a unit. In 2005, the Attorney General’s Office collected $27.9 million from providers who defrauded the Medicaid program.

Inquiries from consumers should be directed to consumer@ago.mo.gov or 1-800-392-8222 (from within Missouri) or 573-751-3321 (outside Missouri).

All media inquiries should be directed to Press Secretary John Fougere.

E-mail      Phone: 573-751-8844         Fax: 573-751-5818