1 / 15

Welcome and Introductions

August 2007. 2. III.Identify Current Issues. Quality Encounter Data NeededEnforcement of Contract Requirements - Written Documentation/Actual Practices, Corrective Action PlanFraud and Abuse Information Sharing, Reporting Systems ? MC Plans Need to Report Problem Providers Reimbursement Metho

taite
Download Presentation

Welcome and Introductions

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. August 2007 1 Welcome and Introductions Guidelines for Addressing Fraud and Abuse in Medicaid Managed Care (October 2000) http://www.cms.hhs.gov/FraudAbuseforProfs/02_MedicaidGuidance.asp#TopOfPage NOTE: Scroll to bottom of page and select Managed Care - click on fraudgd.pdf. Guidelines for Constructing a Compliance Program for Medicaid Managed Care Organizations and Prepaid Health Plans (May 2002) http://www.cms.hhs.gov/FraudAbuseforProfs/02_MedicaidGuidance.asp#TopOfPage NOTE: Scroll to bottom of page and select Managed Care – click on mccomplan.pdf. The Florida Senate Interim Project Report 2006-133 (November 2005) http://www.flsenate.gov/Publications/2006/Senate/reports/Workprogram/pdf/workprogram.pdf (Page 97) Ohio Performance Audit (December 2006) http://www.auditor.state.oh.us/AuditSearch/Reports/2006Ohio_MedicaidProgram_12_19.pdf NOTE: This file will take approximately 11 minutes to download.

More Related