HHS OIG Reports to Congress

The U.S. Department of Health and Human Services Inspector General Daniel R. Levinson presented its semi-annual report to Congress.

For me, these were the highlights of the report:

Medicare and Medicaid Information Systems and Data Security Reports Information Systems: Usefulness of Medicaid Statistical Information System Data for Detecting Medicaid Fraud, Waste, and Abuse

We determined that Medicaid Statistical Information System (MSIS) data were not
timely, accurate, or comprehensive for detection of fraud, waste, and abuse. The MSIS is the only source of nationwide Medicaid claims and beneficiary eligibility information. CMS collects MSIS data directly from States to, among other things, assist in detecting fraud, waste, and abuse in the Medicaid program. Timely, accurate, and comprehensive MSIS data can assist HHS in meeting Health Care Fraud Prevention and Enforcement Action Team (HEAT) objectives to combat health care fraud.

CORRECTION: They did not determine MSIS was inefficient, I did.  I have developed a timely, accurate and comprehensive system for detection of fraud, waste and abuse in child welfare, and as such, maintain as An Original Source, nationwide data on Medicaid fraud in child welfare. 

Medicaid Fraud Control Units

MFCUs are key partners in the fight against fraud, waste, and abuse in State Medicaid
programs. State MFCUs operate in 49 States and the District of Columbia pursuant to the Medicare-Medicaid Anti-Fraud and Abuse Amendments of 1977 with the objective of
strengthening the Government’s capability to detect, prosecute, and punish Medicaid
fraud. MFCUs investigate and prosecute, or refer for prosecution, providers charged with defrauding the Medicaid program or abusing, neglecting, or financially exploiting beneficiaries in Medicaid-sponsored facilities.

Since 1979, OIG has been responsible for administering the Medicaid fraud control grant program and providing oversight and guidance to State MFCUs. This involves
administering Federal financial grants to MFCUs, assessing the performance of MFCUs,
and partnering with MFCUs in conducting joint investigations and performing other
outreach work. During FY 2008, OIG provided oversight for and administration of
approximately $184 million in Federal grants distributed to the 50 MFCUs.

CORRECTION:  The States Medicaid Fraud Control Units do not do anything, absolutely nothing (except for elementary initiatives out of North Caroline).

Let's hope General Levinson and Congress will finally listen and end Medicaid fraud in child welfare.
HHS OIG Semiannual Report to Congress Fall 2009