OIG explores fraud issues related to COVID-19

The OIG launched an initiative this year to identify and explore areas for increased fraud, waste or abuse (FWA) in health care delivery related to the pandemic. The effort is a collaboration with various Medicaid stakeholders, including providers, MCOs and other Health and Human Services agencies.

Demand for health and human services programs increased with the spread of COVID-19. The federal government and the State of Texas implemented more flexible policies to minimize the negative impacts to client services. The flexibilities were implemented to ensure safety and access to care, but new considerations arose related to potential FWA.

The OIG has been working to identify the areas of greatest risk. Our current focus is on telemedicine and lab work. OIG staff have identified dozens of potential schemes through their research and are developing strategies to mitigate those risks.