The Medicaid Fraud Control Unit performance standards require unit supervisor’s to periodically review ongoing investigations and to note the reviews in the case file. The OIG found 96 percent of the case files at Vermont’s unit did not have supervisory reviews noted in them, according to the report.
The performance standards also require state units to inform the OIG of any individuals convicted of Medicaid fraud within their state within 30 days of the conviction for the purpose of program exclusion. The OIG found, between 2010 and 2013,Vermont’s fraud unit failed to send conviction information to the OIG for 56 percent of convicted individuals within the appropriate time frame, according to the report.
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