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The Office of Inspector General each year performs thousands of activities, including fraud prevention research, financial audits, quality of care reviews, Medicaid eligibility reviews, investigations of employees and contractors, welfare fraud investigations, safety monitoring and special projects aimed at identifying and solving specific problems. 

The activities lead, in some cases, to sanctions against Medicaid providers, recovery of overpayments from Medicaid providers, criminal action against Medicaid providers and public aid clients, restriction of recipients who abuse Medicaid privileges, development of new fraud initiatives and improved security for employees and visitors to government buildings.

Although the OIG will never be able to target every single Medicaid service and welfare transaction, it has been committed to ensuring that each transaction does have the potential of closer scrutiny. More vigilance by the OIG breeds more awareness on the public's part to do the right thing in any transaction involving public monies. That public awareness strengthens the OIG's prevention efforts, which are the first line of defense against fraud and abuse.

Through its multi-faceted activities and initiatives, the OIG has significantly raised the bar so more providers and more recipients may have contact with the OIG. The contacts include: reviews of financial records, inspections of providers and recipients' medical records, on-site provider visits, visits to recipients' homes, telephone calls, letters and face-to-face interviews.

In a single year using a variety of program integrity approaches from record analyses to direct contacts, the OIG examined the activities of more than 8,000 individual Medicaid providers and more than 10,000 individual recipients.

The enhanced monitoring and increased detection mean that vigilance is a reality and scrutiny is always a possibility for every provider and recipient.

For more information on specific initiatives, please refer to OIG's Annual Reports .

 
 

 

 

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