A survey found 18 states had failed to implement a fingerprint-based criminal background check for Medicaid providers prone to fraud before a July 2018 deadline. At the start of 2019, 13 of the 18 states still had not implemented these checks.
OIG said “unscrupulous providers” could have entered states’ Medicaid programs through two loopholes in the provider enrollment process. “If not all high-risk providers undergo criminal background checks, the Federal and State Governments are vulnerable to unscrupulous providers intent on defrauding the Medicaid program,” the agency said.
OIG recommended that CMS enact multiple steps to ensure all states use fingerprint-based criminal background checks when enrolling Medicaid providers.
Read the full report here.
More articles on legal and regulatory issues:
Georgians accused of illegally getting Medicaid coverage from Tennessee
Michigan surgeon accused of $60M billing fraud
14 latest healthcare industry lawsuits, settlements
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
