MPI recovers $22 million in third quarter

Our Medicaid Program Integrity (MPI) team recovered more than $22 million in the third quarter of fiscal year 2020. This division investigates and reviews fraud, waste and abuse allegations against providers; reviews hospital and nursing facility claims and medical records; and screens providers seeking to enroll in Medicaid.

During the last quarter, MPI and OIG Litigation settled a case with a Dallas home health agency. The provider submitted bills

for and was paid for more than the maximum allowable amount of 96 units of private duty nursing for one client on one date of service. During the four-year period investigated, the provider also submitted double claims for the same service, which caused double payments to be issued for the same service. To resolve these allegations, the provider agreed to a settlement amount of $694,673.

To read more about this case, other MPI settlements and recent trends, read the latest OIG Quarterly Report (PDF).