Nursing Home Industry Advocates Complain About Iowa Investigation Unit

Millions of seniors that require long-term care rely on Medicaid to pay for all or part of the services that they receive. As such, many states have established Medicaid Fraud Control Units that are tasked with investigating allegations of Medicaid fraud as well as concerns regarding abuse and neglect in facilities that receive Medicaid funds. However, an agency in Iowa is tasked with also investigating facilities that do not receive Medicaid funds. Industry advocates state that this is government overreach, as the Des Moines Register reports.

In April, the Iowa Department of Inspections and Appeals gave their Medicaid Fraud Unit can pursue fraud and neglect investigations regardless of whether the victims are receiving Medicaid.

The Iowa Health Care Association, a long-term care industry advocate, calls the proposal “overreach” and that the expansion of the unit’s authority was unwarranted.

Medicaid in Iowa provides services to some 680,000 poor or disabled residents. This equates to more than a fifth of the state’s population.

The proposed new regulations would give the state unit the authority to investigate reports of fraud or neglect and abuse at Medicaid-funded health care facilities but also at facilities that receive no Medicaid funding.

However, these proposed state regulations mirror federal rules that give all Medicaid Fraud Control Units the ability to investigate abuse and neglect allegations regardless of whether the facility receives Medicaid funds or not.

However, investigations at Medicaid-funded facilities are a required element of each individual unit, while investigating non-Medicaid facilities are left up to state discretion.