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OIG ramps up Medicaid fraud efforts

Executive Summary

The HHS Office of the Inspector General will increase its presence in the Medicaid fraud arena, Inspector Thomas Sowinski said at a RAPS conference held in Denver May 1-2. Congress recently authorized the agency a "decent" sum of money to hire approximately 30 more agents to be specifically assigned to Medicaid related cases, he said, noting that previously, "we were very limited in the drug cases that we would work." He also said that Part D may increase Medicare fraud investigations. "You are going to see cases that could deal with the formularies for the drug plans, if drug companies or others are enticing them to include their drug on a formulary for another reason than just an effective drug, that might be something we are going to investigate"...

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