The Legislative Oversight Committee on Health and Human Resources Accountability met on August 11, 2026.
First, the Attorney General presented on the Medicaid Fraud Unit. To start, he stated the AG can work with prosecutors to prosecute Medicaid fraud but cannot prosecute themselves. The fraud notification system used to be based on tips but is moving to be data-driven. No systemic fraud has been identified. The AG stated there is concern that there could be Medicaid abuse in the substance abuse area.
The new data investigation system should be ready in the coming months; it has been a slow process. It is a federally mandated program, and the AG is taking a lot of direction from the Department of Justice. Currently, there are 40 to 50 investigations happening.
Next, the Department of Human Services Secretary presented about clothing vouchers. The new Secretary has only been in the role a few weeks, and the issues with the clothing vouchers were happening when he started. A concern was reported about misuse of clothing vouchers. School clothing vouchers in West Virginia used to be actual vouchers, but during the pandemic, the funds were moved onto the EBT card, except for foster children, who receive a check. Parents receive $200 per child annually. Last year, the applications were accepted online, and parents had 30 days to apply. This year, the Governor delayed opening the applications due to a review of TANF. Applications opened on July 20 and were set to close in 30 days or “until the funding was exhausted.” The applications closed on July 27, due to the “overwhelming response.”
The secretary explained that for clothing benefits on the EBT card, 49 percent of funds are pulled out as cash and 50 percent is used at Point-of-Sale devices. The POS devices also include any ATM in the building. The national average of all EBT cash withdrawals is 21% – this is not only the clothing benefits, as the state percentages provided were. For the POS uses, 37% were at multipurpose retailers (Walmart, Target, etc.), 35.5% were ATM withdrawals at banks, 10.5% were at convenience stores, 10% were at clothing retailers, 5.5% were at grocery stores, and 3% were at ATMs in nonbank locations.
All TANF benefits go to the EBT card; the funds on the card are not separated out or distinguished when spending. It is assumed that the first $200 spent on the card is for clothing vouchers, regardless of where it is spent. The Secretary stated more information will be provided regarding the last five years of data and that he is committed to verifying information. He could not provide a total number of applications, applications approved, or when funds would be received by all approved applicants.
Finally, the Commissioner of the Bureau of Medical Services provided an update on Medicaid and the effects of Federal HR 1. The Adult Expansion Program will require some adults to participate in work or activities to keep WV Medicaid coverage beginning January 1, 2027. Current Medicaid members will not be affected until their regularly scheduled renewal in 2027. The qualified activities to receive coverage include 80 hours of employment, community service, educational program, or a combination of the three. The exemptions to this requirement include individuals younger than 19 or older than 64, those currently in or former foster care youth under 26, disabled veterans, those eligible for the Indian Healthcare Improvement Act, those receiving snap and not exempt from SNAP work requirements, those receiving TANF/WVWORKS and have met their work requirement, those participating in a rehabilitation program, those who have been incarcerated within the last three months, and those entitled to or enrolled in Medicare Part A or B.
With these updates, 119,150 individuals in WV’s Medicaid Program are automatically excluded. Of the 37,590 not qualified for mandatory exclusion, 33,130 do not meet requirements and will need to provide additional information regarding employment, schooling, or volunteer service.
