Tuesday, February 2, 2010

State Hindered Medicaid Fraud Investigations

Investigators were stonewalled by the New Mexico Human Services Department(HSD) and Health Department according to the Fraud Division’s 2009 annual report to the Inspector General of the U.S. Department of Health and Human Services.

HSD administers the state Medicaid program with help from the Health Department. The agencies hindered “many” fraud and elder abuse investigations during 2008 and 2009, according to the report.

“It appears that the (HSD) inappropriately filters the information they provide to the Fraud Division,” the report states. “[T]his sterilization has inhibited our ability to access and prosecute both fraud and abuse claims.”

The June 2009 report followed a January 2009 audit by the Legislative Finance Committee, which called for an evaluation of how exactly HSD combats Medicaid fraud.

“It appears that both the (HSD) and Department of Health…review and, on occasion, redirect the Division’s data or documents requests, instead of allowing a free flow of information as anticipated by Medicaid regulations and the Memorandum of Understanding between (HSD) and the Division,” the report states.

Full Article and Source:
State Hindered Medicaid Fraud Investigations, Attorney General's Report Claims

4 comments:

Anonymous said...

A perfect example of a log jam red tape!

Marcia said...

Yes, and it exemplfies why nobody seems to know what's going on or has any real statistics.

jerri said...

i think it's more than red tape i think there is more going on here and we chump taxpayers get the bills is say we are mad as hell and we aint gonna take it anymore

Patrick Henry's reincarnation said...

This is absolutely NOT a case of "red tape". It is a case of state(s) deliberately grabbing FEDERAL FUNDING anyway they can including unlawfully/criminally & they are in a "you scratch my back & I'll scratch yours" covert agreement with the CORPORATE NURSING FACILITY INDUSTRY, et. al. All this fraud is done on the backs of the American taxpayers, in multiple strikes_ not just once. They do it in Pa. & .....many other states.