February 4, 2020

Our Medicaid Program Integrity (MPI) team recovered more than $17 million in the first 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, in collaboration with OIG Litigation, excluded eight attendant care workers from participation in Texas Medicaid. The investigative findings identified attendants clocked in and out as though working for the client when the clients were incarcerated, hospitalized or otherwise not receiving services. A review of records also identified attendants who submitted overlapping time through the Electronic Visit Verification System for two different clients. To read more about this case, other MPI settlements and recent trends, click here  https://tinyurl.com/TxOIGQRs for the latest OIG Quarterly Report.