Iowa 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, June 2022
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Fraud -- legislation & jurisprudence Fraud -- prevention & control Government Regulation Medicaid Iowa
- Genre(s):
- Technical Report
- Abstract:
- What OIG Found. The Iowa MFCU reported exceptionally strong case outcomes for FYs 2019–2021, as compared to similarly sized MFCUs. From the data we reviewed, we found that the Unit generally operated in accordance with applicable laws, regulations, and policy transmittals and the MFCU performance standards. However, we made one finding regarding the Unit’s adherence to MFCU performance standards. (1) Although the Unit operated effectively and achieved high case outcomes, the Unit did not maintain staffing levels in accordance with its approved budget, maintained low staffing levels in relation to State Medicaid expenditures, and experienced significant turnover of investigators and high caseloads. In addition to the finding, we made observations regarding Unit operations and practices, including the following: (1) The Unit took steps to maintain an adequate volume and quality of referrals, but referrals from key sources generally decreased during the review period. (2) The Unit took steps to maintain a continuous case flow and to complete cases within appropriate timeframes. (3) The Unit maintained a positive working relationship with Federal law enforcement partners, including the Office of Inspector General (OIG) and U.S. Attorney’s Offices. What OIG Recommends and How the Unit Responded. To address the finding, we recommend that the Unit assess the adequacy of existing staffing levels, and if warranted, develop a plan to expand the size of the Unit. The Unit concurred with our 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 (25 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918716087506676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918716087506676