Texas Gov. Greg Abbott directs investigation into potential Medicaid fraud

Gov. Greg Abbott has directed state agencies to investigate potential Medicaid fraud In Texas.

Abbott on Friday directed the Texas Health and Human Services (HHS) Office of Inspector General and Texas Health and Human Services Commission (HHSC) to investigate potential Medicaid fraud to safeguard taxpayer money, maintain access for eligible Texans, and ensure efficient healthcare delivery.

"Texas provides critical healthcare services to children, pregnant women, the elderly, and people with disabilities through the state’s Medicaid program," Abbott wrote to the agency heads. "Access to medical services is a key component in supporting these individuals and Medicaid fraud robs taxpayers and impairs their ability to receive necessary healthcare. During my tenure as Governor, Texas has policed the Medicaid program and proactively combatted fraud, but we will strengthen our efforts to further protect taxpayers, preserve access for eligible Texans, and maintain the integrity of Texas’ Medicaid Program."

“Given the recent allegations of Medicaid benefits fraud in other states,” Abbott directed Texas’ HHS OIG and HHSC to take several actions and submit a progress report by March 15.

They were directed to “Perform additional reviews of Medicaid services recently identified by the Trump Administration as susceptible to higher incidences of fraud and adjust OIG resources to investigate those suspected of fraudulent activity that are not already under review.” This includes ensuring all Medicaid Managed Care Organizations (MCO) have fully staffed Special Investigations Units (SIUs) and are completing mandatory investigative activities, and the MCO SIUs receive additional fraud training. The agencies are also directed to implement targeted reviews of MCO policies for Medicaid services most susceptible to fraud.

It’s the third directive Abbott’s issued in roughly 10 days after expansive Medicaid fraud has been reported in Minnesota and other states. The previous two directives did not mention Medicaid fraud.

In Minnesota, at least 98 people have been charged, including 85 Somalians, for their role in an alleged fraud scheme targeting 14 high-risk Medicaid-funded services through Minnesota Department of Human Services programs. Sixty have already been found guilty, with some pleading guilty last month, The Center Square reported.

In Minnesota, Assistant U.S. Attorney Joseph Thompson also recently announced additional indictments stemming from a multi-year investigation into a scheme defrauding Minnesota DHS programs created to help disabled children and adults, including those diagnosed with autism.

Abbott’s directive instructs the agencies to complete a targeted utilization review of autism services and compile findings to produce by June.

On Jan. 5, Abbott issued his first directive, ordering the Texas Workforce Commission and Texas Health and Human Services Commission to investigate the potential misuse of taxpayer money in one program: Texas’ Child Care Services Program (CCSP). That directive does not mention Medicaid fraud even though fraudulent Medicaid payments were central to childcare fraud schemes in Minnesota and elsewhere, The Center Square reported.

On Jan. 12, Abbott offered the Trump administration assistance with identifying fraud in taxpayer-funded federal housing programs, The Center Square reported.

In his directives, Abbott claims that Texas state agencies “already have strong anti-fraud processes” and are “well positioned” to help the federal government identify fraud.

In July, 55 people involved in a $15 billion healthcare fraud scam were federally charged in the Houston area, The Center Square reported.

Abbott’s directive also instructs Texas’ HHS OIG to make the public aware of its online fraud reporting portal and hotline for Texans to report potential instances of fraud in the Texas Medicaid program.

Texans are encouraged to report any type of healthcare or Medicaid fraud to the HHS OIG online, by email, oig.generalinquiries@hhs.texas.gov, or by phone: 800-436-6184.