Hawai’i Medicaid Fraud Control Unit Completes 2014 Audit Concerns

Attorney General Douglas Chin. State of Hawai’i photo.

The Office of the Inspector General of the United States Department of Health and Human Services commended the Hawai’i Medicaid Fraud Control Unit on Thursday for its efforts in addressing recommendations made in an October 2014 review of the Hawai’i anti-fraud program.

In March, the unit, which operates as part of the State Department of the Attorney General, submitted its Final Management Report in response to a 2014 audit. The audit examined operations from 2010 to 2013. In 2014, the audit cited shortcomings in various areas and recommended six actions to correct them.

A unit of the State Department of the Attorney General, the Hawai’i Medicaid Fraud Control made strides completing recommendations that include the following:

• Recommendation 1: Develop and implement effective hiring and training practices that conform to current laws, regulations, and performance standards.
• Recommendation 2: Revise its MOU with the Medicaid agency to reflect current law and practice.
• Recommendation 3: Develop and implement policies and procedures that conform to current laws, regulations, and performance standards.
• Recommendation 4: Establish regular communication with Federal agencies.
• Recommendation 5: Develop and implement procedures to ensure Unit staff investigate cases within the grant authority.
• Recommendation 6: Establish fiscal controls.

The Inspector General issued a letter on Thursday noting that the tasks had been completed, with the exception of making a reimbursement for a temporary investigator who left the unit after working for only eight months. The unit anticipates reimbursing the Federal government within the next month.

All of the Inspector General’s recommendations from the audit have been closed.

“Medicaid fraud takes tax dollars from patients who need coverage and gives it to criminals,” said Attorney General Doug Chin. “The Hawai’i Medicaid Fraud Control Unit took the auditor’s recommendations seriously and addressed them quickly, so that it could continue to improve its services to the public.”

The Hawaii Medicaid Fraud Control Unit investigates and prosecutes provider fraud involving medical assistance programs, as well as patient abuse and neglect statewide.