Preventing fraud, waste and abuse

In fiscal year 2019, the OIG developed a fraud, waste and abuse (FWA) prevention strategy focused on raising awareness of FWA and educating three audiences: Medicaid providers, Medicaid clients, and HHS staff.

The OIG engaged providers by publishing articles in medical association publications and posting a fraud and abuse prevention advisory on the OIG website. Staff leveraged social media channels to warn patients to be wary of marketers who offer cash, gifts or other items to influence their health care decisions.

In fiscal year 2019, Medicaid Program Integrity (MPI) identified a number of personal care attendant cases that included billing for services not rendered. This trend provided an opportunity for prevention through education that included an email to providers with an advisory and letters in English and Spanish for attendants and clients highlighting fraudulent behavior.

OIG staff also held stakeholder meetings with the Attendant Care Services Workgroup and the Medicaid Dental Services Workgroup. The OIG established the groups with Medicaid and CHIP Services and HHSC Regulatory to address select fraud, waste and abuse issues in those areas.

Read more prevention highlights from the fiscal year in our Quarterly Report: https://tinyurl.com/y5xeotja