Office of the Medicaid Inspector General Bart Dickinson, Chief Counsel.

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Office of the Medicaid Inspector General Bart Dickinson, Chief Counsel

Transcript of Office of the Medicaid Inspector General Bart Dickinson, Chief Counsel.

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

PurposeAuthorityDuties

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]