State Medicaid agencies (Medicaid agencies) are required to suspend payments for health care items and services when there is a credible allegation of fraud against the provider, unless "good cause" exists not to suspend payment. Using payment suspensions, when appropriate, is important to protect Medicaid funds: payment suspensions based on credible allegations of fraud can swiftly stop the flow of Medicaid dollars to providers defrauding Medicaid. A payment suspension can remain in place throughout the law enforcement investigation and potential prosecution of the health care fraud case.
Report File
Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Report Number
OEI-09-14-00020
Report Description
Report Type
Inspection / Evaluation
Agency Wide
Yes
Number of Recommendations
1
Questioned Costs
$0
Funds for Better Use
$0
Additional Details