This is one issue the nation’s AGs agree needs to be fixed

IT’S not likely the nation’s 57 attorneys general — this total includes the U.S. territories — find many causes that produce the varied members’ overwhelming support. That 51 of them are asking for help regarding Medicare Part D funds indicates Congress should lend an ear.

In a letter to Sen. Orrin Hatch, R-Utah, chairman of the Senate Finance Committee, and Sen. Ron Wyden, D-Ore., the committee’s ranking member, the attorneys general spell out their concerns regarding millions of dollars they believe should be returned to the states. At issue are funds recovered from pharmaceutical fraud settlements involving prescription drug benefits.

States and the federal government together fund Medicaid. Prior to 2006, the AGs noted, state Medicaid programs paid directly for outpatient prescription drug benefits for individuals covered by both Medicaid and Medicare. States that received a Medicaid recovery would share it with the feds.

Since 2006, Medicare has paid directly for Part D drugs but states have shared in the costs through monthly “clawback” payments. Although Part D changed the cost-sharing structure, the attorneys general say, the states and the federal government have continued to jointly fund outpatient prescription drugs for dual-eligible beneficiaries.

The AGs estimate the states have contributed $80 billion in payments to the federal government for prescription drugs covered by Medicare Part D, and that payments this year are expected to exceed $11 billion.

“Over the past decade,” the AGs say in their letter, “the Federal government has settled numerous national healthcare cases and has recovered hundreds of millions of dollars in Part D funding, but has never returned any of these funds to the states.”

According to the letter, the government has said it’s prevented from returning these funds because of a law, called the Monetary Receipts Act, that requires that “any money received ‘for the Government’ from any source be deposited into the United States Treasury unless Congress has specifically authorized the agency to retain such money.”

The attorneys general argue, though, that the purpose of the Monetary Receipts Act is to keep executive agencies from augmenting their own appropriations. That wouldn’t be the case “when returning Part D recoveries to the very same state Medicaid programs that, along with the Federal government, fund the prescription drug expenditures at issue,” the AGs say.

Simply put, Oklahoma Attorney General Mike Hunter said in a news release last week, implementation of Medicare Part D in 2006 “did not include a reimbursement for the states after fraud charges had been settled.” Oklahoma could certainly use the help in its fight against prescription drug fraud.

The AGs are asking Congress to pass a law authorizing the federal government to share these recoveries with the state “as a matter of equity and fundamental fairness.”

This seems a reasonable request. We’ll see whether a united group of attorneys general can convince a deeply divided Congress of that.