From fiscal year 2011 to FY 2013, Iowa was able to save millions in Medicaid dollars through a program integrity contract with Optum. Some examples of fraud or inappropriate Medicaid claims Optum analysts found included nursing home care claims related to lawn mowing and snow removal and questionable swing bed claims at critical access hospitals.
“We’ve put those who deliberately seek to defraud the system on notice that we’re using some very sophisticated techniques to thwart their efforts,” Jennifer Vermeer, director of Iowa’s Medicaid program, said in a news release. “For those who make mistakes or are misinformed, there’s an educational component to the program that our Medicaid providers have found helpful.”
More Articles on Healthcare Payment Integrity:
CMS to Fine, Exclude Providers Who Repeatedly Abuse Medicare
OIG: HHS’ Top 10 Regulatory, Management Challenges of 2013
CMS Developing New Unified Program Integrity Contractors
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