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Page 1: Office of the Medicaid Inspector General

Office of the Medicaid Inspector General

Bart Dickinson, Chief Counsel

Page 2: Office of the Medicaid Inspector General

Creation of the OMIG

• On April 23, 2013, Act 1499 was signed into law creating the Arkansas Medicaid Inspector General’s Office.

Page 3: Office of the Medicaid Inspector General

Creation of the OMIG

• On April 23, 2013, Act 1499 was signed into law creating the Arkansas Medicaid Inspector General’s Office.

• Now codified Ark. Code Ann. §20-77-2501

Page 4: Office of the Medicaid Inspector General

Creation of the OMIG

• On April 23, 2013, Act 1499 was signed into law creating the Arkansas Medicaid Inspector General’s Office.

• Now codified Ark. Code Ann. §20-77-2501 • Outlines OMIG’s

PurposeAuthorityDuties

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Mission Statement of the Arkansas Medicaid Inspector General

Pursuant to Ark. Code Ann. §20-77-2505, the Office of the Medicaid Inspector General, (OMIG) shall:

(1) Prevent, detect, and investigate fraud and abuse within the medical assistance program;

(2) Refer appropriate cases for criminal prosecution;

(3) Recover improperly expended medical assistance funds;

(4) Audit medical assistance program functions; and

(5) Establish a medical assistance program fraud and abuse prevention.

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OMIG Duties

• Perform former DMS Program Integrity functions including: audits; reviews; and investigations

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OMIG Duties

• Perform former DMS Program Integrity functions including: audits; reviews; and investigations

• Pursue civil and administrative enforcement actions

Page 8: Office of the Medicaid Inspector General

OMIG Duties

• Perform former DMS Program Integrity functions including: audits; reviews; and investigations

• Pursue civil and administrative enforcement actions

• Refer cases of fraud and criminal activity– Providers AND Beneficiary fraud

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OMIG Duties cont.

• Utilize subpoena power for witnesses and documents

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OMIG Duties cont.

• Utilize subpoena power for witnesses and documents

• Recommend and implement policies to reduce fraud and abuse

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OMIG Duties cont.

• Utilize subpoena power for witnesses and documents

• Recommend and implement policies to reduce fraud and abuse

• Monitor, review, and work with DHS/DMS

Page 12: Office of the Medicaid Inspector General

OMIG Duties cont.

• Utilize subpoena power for witnesses and documents

• Recommend and implement policies to reduce fraud and abuse

• Monitor, review, and work with DHS/DMS• Work with Providers

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Work with Providers

• Conduct Educational Programs• Communicate with Providers• Develop Protocols for Self-Disclosure• Establish Policies and Procedures for Audits• Create a Model Provider Compliance Program

Page 14: Office of the Medicaid Inspector General

Features of OMIG website

• Online Referral and Fraud complaint form • Medicaid Fraud Hotline information • Medicaid Provider Exclusion List • Provider Enrollment information • Provider Self-Disclosure Protocol • Provider Compliance Program • News about the Office of the Medicaid Inspector

General • Links to other federal and state agencies or

resources • Education on Medicaid fraud, waste and abuse

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Contact Information

Office of the Medicaid Inspector General P.O. Box 1437, Slot S-414 Little Rock, Arkansas 72203-1437 501-683-8349 FAX: 501-682-8350 _________________________________________________

Jay Shue, Medicaid Inspector General Office of the Medicaid Inspector General 323 Center Street, Ste. 1200 Little Rock, AR 72201 501-683-2976 [email protected]

Bart Dickinson, Chief Counsel Office of the Medicaid Inspector General 323 Center Street, Ste. 1200 Little Rock, AR 72201 501-683-2978 [email protected]

Robin Raveendren, Program Integrity Director Office of the Medicaid Inspector General Donaghy Plaza West, 700 Main Street Little Rock, AR 72201 501-682-8173 [email protected]


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