After the Arkansas Legislature passed a law earlier this year creating a new office of the Medicaid Inspector General, the agency has been setting up it independent operations and has recently created a new website. Director Jay Shue says the website will provide a chance for anyone to report any suspected waste, fraud or abuse in the Medicaid payment system.
Any report will lead his staff to review the cases and decide whether or not to investigate, he says.
“If we determine that there's something that prompts a level of civil action or criminal action, then we'd refer that to the appropriate state or federal agency. And we'd work very closely with them in that, providing them assistance with all the work that we have done. But also, oversight is a large portion of what we do and we're also going to be making recommendations to the Medicaid program, [to] make it a more streamlined, well-functioning program.”
Shue, who previously directed the Arkansas Attorney General's Medicaid Fraud Control Unit, says most of the employees in the independent agency were inherited from the Department of Human Services Program Integrity Unit. The newly created office is an independent state agency which investigates possible fraud by both Medicaid recipients and providers.
Shue says the new site will include a hotline, where callers can choose to remain anonymous.
“Some instance of that may be that they see something in the community that they think has to do with Medicaid and they think it may be fraudulent or wasteful or an abuse of taxpayer dollars. They can fill out very minimal information so that we can start an investigation and look into what it is that their concern is,” he says.
An annual report by the agency shows that since fiscal year 2014 began in July, the agency has so far reviewed 136 cases. The Department of Human Services Program Integrity Unit, which handled reports before the independent office was created, reviewed 556 cases in fiscal year 2013
In fiscal year 2013, the report states the Program Integrity Unit recovered $1.1 million in overpayments. So far in fiscal year 2014, the Medicaid Inspector General has recovered $277, 475 in overpayments.
Shue says most of his staff keep their offices inside DHS facilities due to the newness of the agency and a small budget. But they are looking to move headquarters in the coming years, he says, depending on further appropriations decisions by the Legislature and on the availability of different facilities.
According to the Department of Human Services Appropriations Act for the 2013-14 fiscal year, the Medicaid Inspector General's office operates under a budget of about $1.9 million.
A news release says the new website was constructed and designed using grant money.