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
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