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Kansas Medicaid Fraud Control Unit: 2018 onsite inspection
Kansas Medicaid Fraud Control Unit: 2018 onsite inspection
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Reports-in-brief (Promoting Women in Development (Project))
- Contributor(s):
- United States. Department of Health and Human Services. Office of Inspector General. Office of Evaluation and Inspections, issuing body.
- Publication:
- [Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, July 2019
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Fraud -- prevention & control
Medicaid
Kansas
United States - Genre(s):
- Technical Report
- Abstract:
- What OIG Found. The Kansas Medicaid Fraud Control Unit (MFCU or Unit) reported 28 indictments; 32 convictions; 33 civil settlements and judgments; and over $16 million in recoveries for fiscal years (FYs) 2015-2017. From the data and information we reviewed, we found that the Unit operated in accordance with applicable laws, regulations, and policy transmittals. However, we identified one finding involving the Unit’s adherence to MFCU performance standards: (1) Unit investigators and other staff carried large caseloads. In addition to the finding, we made observations regarding Unit operations and practices, the most significant of which were as follows: (1) The Unit conducted outreach to encourage referrals. (2) The Unit's increased use of its electronic case management system allowed more efficient access to case information. (3) The Unit investigated many cases jointly with OIG and actively participated in cases with the United States Attorney’s Office. We also identified the following beneficial practice that may be useful as a model to other Units: (1) The Unit's nurse investigator encouraged referrals to the Unit by working closely with other State agencies. What OIG Recommends. We recommend that the Unit review its caseload management practices and develop an action plan to lower staff members' caseloads. The Unit concurred with the recommendation.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (28 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101757600 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101757600