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MS Medicaid Recovers $8.6M in Fraud, Improper Payments

Mississippi Medicaid fraud, waste, and abuse monitors have recovered $8.6 million in fraudulent or improperly billed payments.

Mississippi Medicaid recovered $8.6 million in fraud

Source: Thinkstock

By Thomas Beaton

- The Mississippi Division of Medicaid (DOM) recovered $8.6 million dollars from claims that were either directly fraudulent or improperly filed, the DOM announced in a press release.

Through collaboration between Medicaid Fraud Control Units (MFCUs) and the DOM Program Integrity Unit, the state of Mississippi was able to recover approximately $6.3 million through third party liabilities, $1.6 million through program integrity, and another $680,000 through financial and performance reviews.

Seven cases of fraudulent billing were referred to an MFCU in the Mississippi attorney general’s office, which identified $3.1 million in improper billings.

The DOM, which is responsible for a $6 billion state Medicaid budget, frequently reviews spending as a measure to holds providers and beneficiaries accountable for program use.

“This is federal and state money that we have a responsibility to recover, but at the same time we put a lot of effort into preventing it in the first place through policy and system changes,” said Dr. David J. Dzielak, executive director of the DOM.

The Attorney General’s office also noted that protecting the Medicaid program from fraud ensures the program’s future and allows it provide services for the state’s most vulnerable patients.

“Our partnership with the Division of Medicaid, specifically the Program Integrity Unit, plays a key role in continuing the fight against fraud in healthcare benefit programs,” saod Attorney General Jim Hood.

“The Medicaid Fraud Control Unit staff is committed to protecting our most vulnerable citizens and the resources needed to serve them. Not only does our partnership allow for the prosecution of those defrauding the program and the prosecution of those abusing and neglecting patients, but it also allows court ordered restitution and penalties in both criminal and civil cases.”


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