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Bill lets Medicaid inspector general use PDMP data for narrow fraud audits
Summary
House Bill 13‑17 was passed by the committee to give the Office of Medicaid Inspector General limited, patient‑specific access to the state Prescription Drug Monitoring Program for audits of Medicaid recipients to detect fraud, waste and abuse; the inspector general emphasized statutory and database limits on broad searches.
Representative Justin Boyd introduced House Bill 13‑17 and invited Elizabeth Smith, the Medicaid inspector general, to explain the measure. Smith said the change would allow her office to use PDMP data "on a person‑by‑person basis" and only for Medicaid recipients, to support audits that start from billing data. "We only are requesting, and we would only need access for Medicaid recipients," Smith said, adding that the office would use PDMP data secondarily after its own billing and data analysis.
Committee members probed safeguards. One senator asked whether the limits described are in statute or rules; Smith and other members said the statutory language would narrow access and the PDMP system’s design limits broad searches. Sponsor and members noted that unauthorized access is a felony under current law, which the sponsor invoked to underscore legal limits on misuse.
After questions, Representative Boyd closed and a senator moved to pass the bill. The committee voted "aye" and the measure passed out of committee.
The change applies only to Medicaid oversight and, according to testimony, is designed to target suspected fraud, waste and abuse rather than permit broad investigatory searches of PDMP records.
