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DHS: Empower partial suspension imposed after Medicaid Fraud Control Unit findings; claims and services continue with oversight
Summary
Department of Human Services staff told the Senate committee that the Medicaid Fraud Control Unit referred credible allegations concerning Empower; the Medicaid Inspector General imposed a partial suspension that allows claim payments and beneficiary services to continue while restricting administrative expenditures and new beneficiary assignments and requiring enhanced oversight.
Department of Human Services officials updated the Senate Public Health, Welfare and Labor Committee on Empower, the Medicaid managed-care contractor undergoing a mandated corporate split from Beacon and a concurrent fraud review.
"MFCU made that determination," DHS staff said, describing a Medicaid Fraud Control Unit finding that there were credible allegations of fraud connected to Empower. The Medicaid Inspector General then imposed a partial suspension: Empower may…
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