Enhanced investigative powers sought for Medicaid fraud

Concerns about patients' privacy were aired Friday as Nevada lawmakers debated a bill that would make it easier for the state attorney general to get access to medical records in efforts to prevent Medicaid fraud.

AB42, authorizing subpoenas for such records, is one of several bills being reviewed by legislators that would expand investigative powers of law enforcement at the state and local level.

Mark Kemberling, a chief deputy attorney general for Nevada, told the Assembly Judiciary Committee that the change would allow the office to obtain patient medical records more easily, and argued that getting a judge to issue a search warrant can be more disruptive.

Judiciary Chairman Bernie Anderson, D-Sparks, cautioned against setting a precedent for other government agencies, and challenged wording in AB42 that would give the subpoena power to any "designee" of the head of the attorney general's Medicaid fraud unit.

"Who do you have to run this by?" Anderson asked. "Do you just get to do it?"

The concerns about the "designee" wording voiced by Anderson and other Judiciary members prompted Kemberling to agree to an amendment striking that provision from the bill.

Kemberling said the Medicaid fraud unit investigates dozens of cases of fraud every year.

The most common type of case involves medical care providers who submit claims for services that they didn't provide, or that they provided at a lower cost.

The Medicaid fraud unit would seek mostly billing records, and patients would not have to be notified that their records were requested, Kemberling said.

"It's a pretty broad power to access people's medical records," Assemblyman Ty Cobb, R-Reno, said after the hearing. "My concern, first and foremost, was for the privacy of Nevada citizens, and also to understand from law enforcement why they needed this specific power.

"In the end, they made some good arguments about why we need to root out as much fraud as possible in the system, so I'm thinking that this bill will garner our support."