Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Fraud topic
No spam. Unsubscribe anytime.
TennCare says provider fraud is primary concern; member fraud tracked by OIG
Summary
TennCare officials told the committee they have a multi-agency approach to address provider fraud and that member fraud is handled by the Office of Inspector General; agency representatives said they can provide conviction counts on request.
When members raised national reporting about provider fraud in Medicaid-like programs, TennCare Director Steven Smith told the committee Tennessee has an active multi-agency approach that involves TennCare, the Office of Inspector General (OIG), the Tennessee Bureau of Investigation and the attorney general's office.
Smith said recent activity has been concentrated in provider fraud and that member fraud is addressed aggressively by OIG. He offered to provide the committee with conviction and enforcement numbers from the last several years. In response to concerns about illegal immigration and program eligibility, Smith said, "We are prohibited from serving anyone here illegally within the Medicaid program," and added he does not believe such coverage is occurring.
Members asked for historical data on fraud convictions and for specifics about how cross-state fraud or residency issues will be identified more quickly under new federal systems described in the legislation.
