Below are three findings from the OIG’s reports:
- None of the Medicaid Fraud Control Units reviewed had all of the proper documentation in their case files. Each of the state units was missing either documentation of periodic supervisory reviews or documentation of supervisory authority to open or close a file. Texas was the best performing fraud unit in this category, with 98 percent of its case files containing all required documentation.
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Six of the state fraud units did not refer convicted individuals to the OIG within 30 days, as required by the performance standards. Minnesota and Arkansas were the two states who successfully referred all convicted individuals to the OIG within the appropriate time period.
- Three of the state fraud units did not have an up-to-date Memorandum of Understanding containing current law. The memorandums in place at the fraud units in Arkansas, Michigan and Minnesota all lacked the law which requires payment suspension of any provider against whom there is a credible allegation of fraud.
More Articles on Medicare Fraud:
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