Vol 30, No. 6, #9. Protecting Wyoming's Vulnerable Adults.

• Author: Author: Steven D. Olmstead

Wyoming Bar Journal

2007.

Vol 30, No. 6, #9.

Protecting Wyoming's Vulnerable Adults

Wyoming Bar JournalVol 30, No. 6, #9Issue: December, 2007Author: Steven D. OlmsteadProtecting Wyoming's Vulnerable AdultsThe Medicaid Fraud Control Unit (MFCU) of the Wyoming Attorney General's Office operates in response to federal mandate (Public Law 95-142, Implemented by Title XIX of the Social Security Act, 42 USC 1396), to identify, investigate, and prosecute Medicaid fraud perpetrated by providers of the full range of medical services and assistance under the Medicaid program and fraud in the administration of the program. The Medicare-Medicaid Anti-Fraud and Abuse Amendments, which authorized the establishment and funding for Medicaid Fraud Control Units, were passed by both Houses of Congress and signed into law on October 25, 1977. The objective of this law, Public Law (P.L.) 95-142, was " . . . to strengthen the capability of the Government to detect, prosecute, and punish fraudulent activities under the Medicare and Medicaid programs. . ."

Pursuant to this same law, the MFCU also identifies, investigates, and prosecutes abuse to patients of health care facilities that receive Medicaid funds, misappropriation of patient's private funds in such facilities, as well as patient abuse in non-Medicaid funded board and care facilities (expanded authority in accordance with Pub. Law 106-170). Pursuant to the federal law, this investigation/prosecution program of the MFCU must be separate and apart from the Medicaid program operated by the single state agency within the Wyoming Department of Health. The governing federal regulations for the MFCU are located at 42 CFR 1007, et seq.

In 1994, the Wyoming Legislature appropriated funds to the Office of the Attorney General to establish a Medicaid Fraud Control Unit. The MFCU derives its state authority from this legislation and an Executive Order of the Governor of the State of Wyoming. The Attorney General, through the MFCU, shall investigate any allegations of Medicaid fraud or abuse arising in any county of the State of Wyoming involving providers of Medicaid services. Additionally, unit attorneys may be appointed as Special Assistant United States Attorneys for the prosecution of fraud cases in the United States District Court for the District of Wyoming.

The Wyoming MFCU operates in...