Story misleads on efforts to stop Medicaid fraud

I’m used to the disparaging barbs from the editorial page about Attorney General Ken Cuccinelli and this office, but The Roanoke Times does a public disservice when that bias bleeds over to the news side. No matter what political philosophy your readers espouse, one thing they should demand from this paper is to be trusted with the facts.

While reporter David Ress had all the facts before he wrote his article on the successful efforts by the attorney general’s office to stop Medicaid fraud (“Virginia’s Medicaid fraud unit gets modest ranking”), he certainly did his best to hide them from his readers.

Ress selectively chose statistics that didn’t tell the full story, and he tried to make the office’s successes look smaller by dividing them up throughout his article. His premise: The AG’s arm that battles Medicaid fraud (where medical providers bill taxpayers for phony services or use unqualified staff) is underperforming; and while it’s underperforming, the AG is expanding it.

Ress claims the unit’s fraud recoveries have declined since 2008, giving Virginia a terrible 44th-place ranking among the states. The problem is, this premise is based on Ress deliberately leaving out some very important details, such as the national record-breaking $1.5 billion Abbott Labs fraud recovery the unit obtained in 2012.

The real facts are that in Cuccinelli’s 3 1⁄2 years as attorney general, the office’s Medicaid fraud convictions have led to a record $1.58  billion in court-ordered restitution, fines and penalties. That totals more in recoveries than all Virginia attorneys general combined since the unit was created in 1982. And the Abbott case was the largest case ever investigated by a state. No other state has even come close.

Ress ranked our Medicaid fraud unit based on a single one-year comparison of the fraud recoveries of all states. He was told those numbers weren’t up-to-date and didn’t contain the $1.5 billion — it won’t be reported on the government’s annual report until the federal fiscal year ends Sept. 30.

He was also cautioned that single years couldn’t accurately be compared because the big cases take three or four years to investigate and prosecute. The fact is, after the four largest states in the country (California, Texas, New York and Florida), no other has recovered as much as Virginia over the last three years, five years or 10 years — period. A ranking of No. 44? Hardly.

Ress also asserted that our collections from fraud cases are in decline, even though he had data showing that the office is actually breaking records. Cuccinelli’s recoveries are the highest in Virginia’s history, with the unit breaking its own national record set in the 2007 Purdue Pharma case, the largest case in U.S. history at the time. Every year during the Cuccinelli administration, the unit has brought in more money than any other year in the office’s history before the Purdue case hit.

The unit’s recoveries are growing because fraud is growing and because ours is one of the best-known units in the nation, where even out-of-state whistleblowers come with fraud tips because they know our investigators and prosecutors crack the toughest cases. Cuccinelli has built upon that reputation by nearly doubling the unit — from 56 to 96 investigators and prosecutors — to take on more cases.

Here’s why: Our recoveries have averaged $3.1 million per employee annually over the last five years. Adding employees is netting millions more in recoveries for Virginia; in other words, we recover more in stolen taxpayer dollars than we spend on those additional salaries. Those increased recoveries also mean the budget won’t run out of money for health care for the poorest Virginians before year-end.

Ress included many quotes from me in his story, presumably so he could say he was being fair. But the problem is, his negative premise permeated the article — a premise that’s just not supported by the facts, and one that led his readers to believe something that was 180 degrees from the truth.

The people deserve to know what their government is doing — both the good and the bad — and that’s part of a newspaper’s role.

If The Times doesn’t want to report the many success stories of our office (and it often doesn’t), then that’s its choice. But it shouldn’t spin the facts to take a program all Virginians should be cheering as a success story and turn it into a cheap shot merely to disparage an attorney general its editors don’t care for. In doing so, The Times does a disservice to its readers and to all the investigators, attorneys and law enforcement personnel who work daily to stop those who cheat the taxpayers and steal medical care from the neediest among us.

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