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Connecticut Medicaid Fraud Control Unit: 2021 inspection
Connecticut Medicaid Fraud Control Unit: 2021 inspection
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Report in brief (United States. Department of Health and Human Services. Office of Inspector General)
- 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, September 2022
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Fraud -- legislation & jurisprudence
Fraud -- prevention & control
Government Regulation
Medicaid
Connecticut - Genre(s):
- Technical Report
- Abstract:
- What OIG Found. From the information we reviewed, we found that the Connecticut MFCU generally operated in accordance with applicable laws, regulations, and policy transmittals. However, we made four findings regarding the Unit’s adherence to the MFCU performance standards and compliance with Federal regulations: 1. During our review period, the Unit did not receive referrals of patient abuse or neglect and was unable to take sufficient steps to ensure that it received such referrals. 2. The Unit lacked a central repository for case information, making access to case data and pertinent case documents inefficient. 3. The Unit did not adhere to its policy of documenting supervisory reviews monthly. 4. The Unit did not consistently report convictions or adverse actions to Federal partners within the appropriate timeframes. In addition to the findings, we made several observations regarding Unit operations and practices. What OIG Recommends. To address the findings, we recommend that the Unit (1) develop and implement outreach efforts to ensure that the Unit regularly receives referrals of patient abuse and neglect; (2) seek approval from OCSA to implement a new case management system; (3) conduct and document supervisory reviews of case files in accordance with Unit policy; and (4) ensure that all convictions and adverse actions are reported to Federal partners within the appropriate timeframes. The Unit concurred with all four recommendations.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (30 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918715888506676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918715888506676