Legislative auditors say Medicaid inspector general failed to provide adequate oversight

Legislative auditors told the General Government Appropriations Subcommittee that the Office of Inspector General (OIG) of Medicaid Services has not adequately fulfilled its statutory mandate to oversee Utah Medicaid.

The Legislative Auditor General’s Office presented findings that the OIG’s audit coverage is narrow, its public reporting contains unexplained changes and errors, and management and governance weaknesses have limited the office’s effectiveness. Auditors recommended a menu of structural options — from creating an accountability board to separating the audit function or moving program-integrity work into another agency — and urged the Legislature to consider changes.

Auditors said the OIG was created following a 2011 Medicaid audit and began operating in 2012 with two primary functions: a performance/audit function and a program-integrity division that investigates fraud, waste and abuse. Jesse Martinson, audit manager with the Office of the Legislative Auditor General, said auditors reviewed OIG work since the last audit and concluded the office “has not adequately fulfilled its mandate to provide oversight of Medicaid.” Mathias Spoon, an audit supervisor, told the subcommittee that 80% of the OIG’s work since…