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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-06-19-00110
Report Description

The purpose of this review was to identify and address factors that contributed to the Hawaii Medicaid Fraud Control Unit's (MFCU's or Unit's) low case outcomes during federal fiscal years (FYs) 2016-18 and to assess Unit operations. In 2015, OIG issued a report from its 2014 onsite review of the MFCU that raised concerns about the Unit's ability to carry out its statutory functions and meet program requirements. To address the deficiencies identified during OIG's previous onsite review, the MFCU developed and implemented a corrective action plan. Despite this effort, we found that the Hawaii MFCU's case outcomes were low during FYs 2016-18, compared to other similarly sized MFCUs.

Report Type
Inspection / Evaluation
Location

HI
United States

Additional Details
https://oig.hhs.gov/oei/reports/oei-06-19-00110.asp
External Entity
State of Hawaii

Open Recommendations

This report has 2 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
6404 No $0 $0

Revise the Unit’s agreement with Adult Protective Services to establish minimum criteria for a complaint to be sent to the MFCU

6402 No $0 $0

Develop and implement a plan to increase Medicaid fraud referrals from the Medicaid agency and other stakeholders

Department of Health & Human Services OIG

United States