Medicaid Scams Waiver Authorized by DHHR

Charleston– Recently, a waiver that will enable the West Virginia Department of Health and Human Resources to carry out information mining activities developed to find Medicaid scams was authorized. The waiver was granted by the U.S. Health and Human Services, Office of Inspector General.

” This waiver enables DHHR’s Medicaid Fraud Control Unit to proactively evaluate Medicaid claims using information analytics and analytical modeling to reveal patterns and activities that might be a sign of scams,” DHHR Inspector General Kathy Lawson stated.

West Virginia signs up with just 9 other states that have effectively gotten the waiver from the United States Health and Human Services, Office of Inspector General. Funding for these information mining activities will come mainly from federal coordinating funds.

The Medicaid Fraud Control Unit, through DHHR’s Office of Inspector General, examines and prosecutes or refers for prosecution accusations of health care scams dedicated versus the Medicaid program and accusations of the criminal abuse, disregard or monetary exploitation of clients in Medicaid-funded centers and homeowners in board and care centers.