Texas Medicaid Fraud Control Unit Failed to Meet Performance Standards, Says OIG

HHS’ Office of the Inspector General has released the results from its onsite review of the Texas Medicaid Fraud Control Unit that revealed the unit did not meet all of its performance standards by failing to transmit all of its conviction information to the OIG in a timely manner.

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The Medicaid Fraud Control Unit performance standards require state fraud units to inform 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 Texas’ fraud unit failed to send conviction information to the OIG within the required time, and 22 percent of Texas’ fraud unit convictions were not reported to the OIG until more than 90 days after sentencing.

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Penalties for Medicaid Fraud Enhanced in Kansas 

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