(Iowa Medicaid Card - KIWA Staff Photo)Iowa (RI) — A task force appointed by Gov. Kim Reynolds has released a series of recommendations aimed at strengthening Iowa’s efforts to detect and prevent Medicaid fraud.
Among the recommendations is a 60% increase in staffing for Iowa’s Medicaid Fraud Control Unit, along with expanded use of technology, including artificial intelligence, to identify suspicious billing patterns and other potential signs of fraud.
Attorney General Brenna Bird, who chaired the task force, said the recommendations mark the beginning of a broader effort to protect taxpayers and Medicaid recipients.
Governor Reynolds created the task force in July and directed members to develop recommendations by the end of October.
Among the proposals are electronic verification of services such as in-home care visits and expanded use of data analysis tools to help investigators identify potential fraud.
Iowa Solicitor General Eric Wesson helped write the report, which will be submitted to the governor before it is released to the public.
Bird and the task force is also recommending that Medicaid fraud be classified as a felony, similar to private insurance fraud, and that payments to providers facing credible fraud allegations be suspended while investigations are underway.
Bird said the state’s fraud unit currently has only nine employees and argued additional personnel are needed.
Not everyone supports the recommendations.
Former Iowa Medicaid Fraud Control Unit Director Kevin Techau criticized the effort, arguing the state could have expanded its fraud-fighting capacity years ago through additional federal funding.
Techau also questioned the makeup of the task force and said key voices were left out of the discussion, such as Democrat Rob Sand and the state auditor’s office.
Some recommendations could be implemented administratively before Reynolds leaves office, while others would require approval from the Iowa Legislature and the next governor in 2027.
