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Feds cite Indiana Medicaid fraud unit over notices

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A federal agency found that the Indiana attorney general's office didn't give proper notice in nearly a quarter of the Medicaid fraud cases it helped prosecute in recent years.

A report from the Department of Health and Human Services inspector general's office found state officials didn't notify the agency within 30 days in about 25 of its 105 convictions between fiscal years 2010 and 2012. In 11 of those cases, the federal government wasn't notified at all, The Indianapolis Star reported.

Overall, the inspector general's office said Indiana is performing well, but it cited six criticisms, including a failure to document supervisor approval in about 77 percent of open cases and 18 percent of closed cases.

Matthew Whitmire, director of Indiana's Medicaid Fraud Control Unit, admitted state investigators hadn't met the 30-day notification requirement in some cases. He said the delays were the result of Indiana's prosecution system, which forces the fraud office to go through county prosecutors, who sometimes don't update it on the status of cases.

"The lack of prosecution power and reliance on 91 county prosecutors makes the 30-day requirement unreasonable," Whitmire wrote in a letter to the inspector general's office. But he said the agency will try to comply.

It is unclear whether anyone convicted of fraud later received any federal payments.

Bryan Corbin, spokesman for the state attorney general's office, said investigators work closely with the Family and Social Services Administration to ensure people convicted of fraud are not paid federal funds. State officials also seek restitution for any improper payments.

The fraud unit recovered more than $110 million in civil and criminal convictions between fiscal year 2010 and 2012, according to the report.

"We made some findings, but nothing that would question their basic ability to investigate fraud and patient abuse and neglect," said Richard Stern, director of the Medicaid Fraud Policy and Oversight Division in the inspector general's office.
 

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