Nevada AG proposes broader civil investigatory powers, tweaks false-claims and records penalties in Medicaid fraud bill

The Office of the Attorney General presented Assembly Bill 15 to the Nevada Assembly Judiciary Committee on a hearing that explored changes to how the state investigates and prosecutes Medicaid-related fraud.

Jessica Perlick, senior deputy attorney general in the Medicaid Fraud Control Unit, told the committee the unit is staffed by attorneys, law enforcement, civil investigators, auditors and analysts, and that it is federally funded about 75 percent by grant. “We investigate provider fraud. We do not investigate recipient fraud,” Perlick said, and she described examples such as upcoding, billing for services not provided and pharmacy overbilling.

The bill would do three things, Perlick said. First, it would expand the unit’s civil investigatory authority to allow subpoenas that compel sworn depositions and interrogatories of providers in civil investigations, not only document subpoenas. Perlick said the provision is modeled on statutes in Massachusetts and Ohio and resembles the federal civil investigative-demand authority under 31 U.S.C. § 3733, which federal investigators use in qui tam and other matters. “This is not something that would be unusual to practitioners in this arena,” she said.

Second, part 2 would revise language in the Nevada False Claims Act so it conforms more closely to the Federal False Claims Act. Perlick told legislators a recent Nevada Supreme Court decision (referred to in the hearing as Orbits) identified a textual distinction that could reduce Nevada’s share of recoveries under the federal FMAP/SMAP split. “The current split is 51/49 in favor of the federal government,” she said; if Nevada’s statute is found not to conform to the federal statute, Perlick said the state’s retained portion could fall by 10 percentage points, from roughly 49 percent to about 39 percent of recoveries.

Third, the bill would modify a criminal records offense—identified in committee testimony as NRS 422.570—by adding a misdemeanor tier where only a gross misdemeanor is presently available. Perlick explained that adding a misdemeanor option would “help us to more conform the punishment to fit the crime” and give prosecutors greater flexibility to negotiate resolutions short of a gross misdemeanor conviction.

Committee members pressed presenters on several points during Q&A. Assemblymember Gray asked whether providers could be charged federally or by the state; Perlick said the office has done joint cases and can refer matters to the U.S. Department of Justice, HHS OIG or the FBI, and that those federal agencies can pursue their own actions and keep any recoveries from cases they take over. Assemblymember Dahlia asked whether the $650 dividing line between misdemeanor and gross misdemeanor referenced in the bill is tied to caseload or statutory conformity; Perlick said it conforms with other portions of the Medicaid fraud statutory scheme.

Several lawmakers raised concerns about provider burden. Assemblymember Yurek asked whether similar statutes in other states had led providers to stop participating in Medicaid; Perlick said she had no numeric data on provider enrollment declines but offered to try to obtain such information. Chief of Staff Teresa Benitez Thompson added the office could provide historic prosecutions and examples showing the types of egregious conduct the unit pursues.

On who would face criminal charges for records offenses, Perlick said prosecutorial decisions about specific targets (owners, managers or other staff) follow substantial investigation; she noted a statutory provision that can impute responsibility to owners of facilities or practices but deferred to criminal prosecutors for precise charging standards. Attorney General Aaron Ford emphasized the office’s stated goal of aligning punishment to fit the offense: adding a misdemeanor option, he said, permits justice to be “effectuated in the way that is most appropriate under the circumstances.”

There was no public testimony in support, opposition or neutral testimony recorded for AB 15 during the hearing. Committee members asked the office to provide updated referral and prosecution statistics (for example, referrals received and civil and criminal complaints filed for 2024) and to update material in the unit’s biannual report to reflect recent activity.

The committee closed the hearing on AB 15 after questions and invited the presenters to submit the requested background and statistics.