An OIG report shows states continually fail to inform the OIG when they prohibit healthcare providers from Medicaid programs for incompetence, fraud, or abuse.

 

Federal law requires states to report deficient providers to the OIG so the OIG can include the providers on its reimbursement exclusion list. Not following this law makes it easy for these providers to set up services in a different state and/or continue to receive reimbursements from the Medicaid program.

 

The OIG found that 61% of the 4,319 sanctions imposed by state Medicaid agencies in 2004 and 2005 were not on the federal list. Several state officials said they were uncertain about the kind of information they were required to provide to the OIG.

 

The agency will “strive to reduce the barriers that may currently exist” I order to increase the number of referrals from states, said CMS spokesperson Jeff Nelligan in a San Francisco Chronicle article.