OIG provides new reference for MCOs
Managed Care Organizations (MCOs) have a new chapter in the Uniform Managed Care Manual (UMCM) that consolidates existing Office of Inspector General (OIG) deliverables and guidance into one place.
OIG recovers nearly $145 million in third quarter
The Office of Inspector General recovered nearly $145 million in the third quarter of fiscal year 2019.
OIG audit finds overpayment to DME provider
An OIG audit has found that a durable medical equipment provider submitted unsupported and unauthorized claims, resulting in overpayments.
OIG issues advisory on dental services
The OIG has issued a fraud and abuse prevention advisory about dental services.
OIG rolling audit plan updated
The OIG has updated its rolling audit plan, which outlines potential audit areas and topics.
OIG conducts inspection of PBM program integrity activities
The OIG conducted an inspection to determine the program integrity activities pharmacy benefit managers (PBM) use to detect fraud, waste, and abuse of Medicaid-funded prescriptions.
OIG finds incorrectly reported encounter data
The results of an OIG audit found that a Texas Medicaid and Children’s Health Insurance Program (CHIP) managed care organization (MCO) incorrectly reported encounter data.
OIG inspection finds issues with power wheelchair suppliers
The OIG completed an inspection to determine if documentation requirements are being met when Medicaid clients receive power wheelchairs from DME (durable medical equipment) suppliers.
OIG recovers $98 million in second quarter
The Office of Inspector General recovered nearly $98 million in the second quarter of fiscal year 2019, identified almost $42 million for future recoveries, and achieved $37 million in cost avoidance.
OIG conducts inspection of MCO complaint reporting processes
The OIG conducted an inspection to determine if managed care organization member complaint intake processes are consistent with the Uniform Managed Care Contract and Uniform Managed Care Manual requirements.