Transcript Office of the Medicaid Inspector General

Office of the Medicaid Inspector General
Bart Dickinson, Chief Counsel
Creation of the OMIG
• On April 23, 2013, Act 1499 was signed into law
creating the Arkansas Medicaid Inspector General’s
Office.
Creation of the OMIG
• On April 23, 2013, Act 1499 was signed into
law creating the Arkansas Medicaid Inspector
General’s Office.
• Now codified Ark. Code Ann. §20-77-2501
Creation of the OMIG
• On April 23, 2013, Act 1499 was signed into
law creating the Arkansas Medicaid Inspector
General’s Office.
• Now codified Ark. Code Ann. §20-77-2501
• Outlines OMIG’s
Purpose
Authority
Duties
Mission Statement of the Arkansas Medicaid Inspector General
Pursuant to Ark. Code Ann. §20-77-2505, the Office of the Medicaid Inspector General,
(OMIG) shall:
(1) Prevent, detect, and investigate fraud and abuse within the medical assistance
program;
(2) Refer appropriate cases for criminal prosecution;
(3) Recover improperly expended medical assistance funds;
(4) Audit medical assistance program functions; and
(5) Establish a medical assistance program fraud and abuse prevention.
OMIG Duties
• Perform former DMS Program Integrity
functions including: audits; reviews; and
investigations
OMIG Duties
• Perform former DMS Program Integrity
functions including: audits; reviews; and
investigations
• Pursue civil and administrative enforcement
actions
OMIG Duties
• Perform former DMS Program Integrity
functions including: audits; reviews; and
investigations
• Pursue civil and administrative enforcement
actions
• Refer cases of fraud and criminal activity
– Providers AND Beneficiary fraud
OMIG Duties cont.
• Utilize subpoena power for witnesses and
documents
OMIG Duties cont.
• Utilize subpoena power for witnesses and
documents
• Recommend and implement policies to
reduce fraud and abuse
OMIG Duties cont.
• Utilize subpoena power for witnesses and
documents
• Recommend and implement policies to
reduce fraud and abuse
• Monitor, review, and work with DHS/DMS
OMIG Duties cont.
• Utilize subpoena power for witnesses and
documents
• Recommend and implement policies to
reduce fraud and abuse
• Monitor, review, and work with DHS/DMS
• Work with Providers
Work with Providers
•
•
•
•
•
Conduct Educational Programs
Communicate with Providers
Develop Protocols for Self-Disclosure
Establish Policies and Procedures for Audits
Create a Model Provider Compliance Program
Features of OMIG website
•
•
•
•
•
•
•
Online Referral and Fraud complaint form
Medicaid Fraud Hotline information
Medicaid Provider Exclusion List
Provider Enrollment information
Provider Self-Disclosure Protocol
Provider Compliance Program
News about the Office of the Medicaid Inspector
General
• Links to other federal and state agencies or
resources
• Education on Medicaid fraud, waste and abuse
Contact Information
Office of the Medicaid Inspector General
P.O. Box 1437, Slot S-414
Little Rock, Arkansas 72203-1437
501-683-8349
FAX: 501-682-8350
_________________________________________________
Jay Shue, Medicaid Inspector General
Office of the Medicaid Inspector General
323 Center Street, Ste. 1200
Little Rock, AR 72201
501-683-2976
[email protected]
Bart Dickinson, Chief Counsel
Office of the Medicaid Inspector General
323 Center Street, Ste. 1200
Little Rock, AR 72201
501-683-2978
[email protected]
Robin Raveendren, Program Integrity Director
Office of the Medicaid Inspector General
Donaghy Plaza West, 700 Main Street
Little Rock, AR 72201
501-682-8173
[email protected]