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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
Federal Reports
Report Date
Agency Reviewed / Investigated
Report Title
Type
Location
Department of Health & Human Services
Medicaid Fraud Control Units Fiscal Year 2016 Annual Report
The Department of Health and Human Services (HHS) OIG is the designated Federal agency that oversees State Medicaid Fraud Control Units (MFCUs or Units). This MFCU Fiscal Year (FY) 2016 Annual Report highlights statistical achievements from the investigations and prosecutions the 50 MFCUs conducted for FYs 2012 through 2016. The report also identifies beneficial practices noted in OIG onsite review reports.
The audit assessed the effectiveness and adequacy of management controls in place for refiles of IRS records at six FRCs: Atlanta, Dayton, Kansas City, Kingsridge, Lee’s Summit, and Lenexa.
The New York State Department of Health used the correct Federal medical assistance percentages when processing Medicaid claim adjustments for both public and private providers during the period October 2008 through June 2011. Accordingly, this report contains no recommendations.
CIGNA Government Services, LLC, a subsidiary of CIGNA Corporation, claimed unallowable postretirement benefit costs of $281,000 for Medicare reimbursement for fiscal years 2004 through 2012.
