OIG spends $75M on Medicaid oversight, recommends cost-saving measures

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The Department of Health and Human Services Office of Inspector General spent $75 million on Medicaid oversight during the last fiscal year, a 4% increase over fiscal 2012, according to a new report.

The Medicaid Integrity Program Report for Fiscal year 2013 includes examination of recovery of Medicaid overpayments, wasteful policies and practices, legal activities and beneficiary eligibility.

Among the findings:

  • More than 75% of beneficiaries in seven selected states were receiving home- and community-based services in assisted living facilities with at least one deficiency related to state licensure or certification.
  • New York's Medicaid program could have saved $5.9 million in a year by putting diabetes test strips through competitive bidding.
  • North Carolina could have a state recovery of at least $1.2 million if it enhanced efforts to recover overpayments in provider accounts.

Medicaid program integrity reviews make up 30% of all OIG healthcare oversight obligations.

The full report can be seen here.

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