Fraud & Abuse
Policy Statement on Fraud and Abuse
States should be encouraged to partner with Medicaid health plans to identify and curtail waste, fraud and abuse in Medicaid. With advanced claims processing systems, data reviews and analytic tools, health plans are better able to identify irregular billing patterns and find outliers that may need corrective action. MHPA supports efforts to strengthen the cooperation between states and health plans in fighting fraud. Such efforts should involve clear, consistent communications on the expectations of the plans, and should not involve additional unfunded administrative burdens. Medicaid health plans are positioned to serve as leaders in eliminating fraud and abuse in Medicaid to protect taxpayer dollars.
Policy Activity
MHPA Letter in Support of the National All Schedules Prescription Electronic Reporting (NASPER) Reauthorization ActOn November 3, 2011, MHPA sent a letter to Congress supporting the reauthorization of NASPER as part of its efforts to help reduce waste, fraud and abuse in the Medicaid program. Click here to read the letter.
MHPA Letter to HHS on Medicaid Health Plan Participation in Fraud and Abuse Prevention SummitOn November 24, 2009, MHPA sent a letter to the Department of Health and Human Services encouraging the agency to include Medicaid health plans in a planned summit on Medicare and Medicaid fraud. Deputy Secretary Bill Corr named a number of stakeholder groups that would be invited to participate in the agency's ongoing efforts to address fraud, but Medicaid health plans were not named. Click here to read the letter.
States should be encouraged to partner with Medicaid health plans to identify and curtail waste, fraud and abuse in Medicaid. With advanced claims processing systems, data reviews and analytic tools, health plans are better able to identify irregular billing patterns and find outliers that may need corrective action. MHPA supports efforts to strengthen the cooperation between states and health plans in fighting fraud. Such efforts should involve clear, consistent communications on the expectations of the plans, and should not involve additional unfunded administrative burdens. Medicaid health plans are positioned to serve as leaders in eliminating fraud and abuse in Medicaid to protect taxpayer dollars.
Policy Activity
MHPA Letter in Support of the National All Schedules Prescription Electronic Reporting (NASPER) Reauthorization ActOn November 3, 2011, MHPA sent a letter to Congress supporting the reauthorization of NASPER as part of its efforts to help reduce waste, fraud and abuse in the Medicaid program. Click here to read the letter.
MHPA Letter to HHS on Medicaid Health Plan Participation in Fraud and Abuse Prevention SummitOn November 24, 2009, MHPA sent a letter to the Department of Health and Human Services encouraging the agency to include Medicaid health plans in a planned summit on Medicare and Medicaid fraud. Deputy Secretary Bill Corr named a number of stakeholder groups that would be invited to participate in the agency's ongoing efforts to address fraud, but Medicaid health plans were not named. Click here to read the letter.
2012 Annual Awards Forum
Register now for the MHPA Center for Best Practices Second Annual Awards Forum, April 30, 2012 from 8:00am to 2:00pm at the U.S. Chamber of Commerce in Washington, DC. This one-day event of industry CEOs, CFOs, CMOs and other key personnel will honor Medicaid health plans for their innovative and effective best practices which have improved the health of Medicaid enrollees. To register or become a sponsor, click here.
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