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News & Press: Regulatory

OIG: $51M Saved Through MA Fraud Detection, Prevention in 2016

Wednesday, July 26, 2017   (0 Comments)
Posted by: Sarah Bass
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The Wisconsin Office of Inspector General saved taxpayers more than $51 million in 2016 through its public assistance fraud prevention and detection efforts, according to the OIG 2016 Annual Report released last week.

Of the $51,159,815 in savings, $32,662,343 was from detection of  benefit overpayments and $18,497,472 was from cost avoidance measures.

The Office of the Inspector General (OIG), created by Governor Walker in 2011, has since then identified $150 million in fraud prevention and detection savings for its Wisconsin Department of Health Services (DHS) programs such as Medicaid and FoodShare. The Fraud Investigation, Recovery and Enforcement (FIRE) Section in the OIG now has 30 staff, including 23 positions to support Medicaid and FoodShare Program fraud prevention and detection activities.

According to the report, the OIG in 2016:
  • Identified more than $9 million in Medicaid provider overpayments and recovered nearly $8 million in overpayments to Medicaid providers.
  • Received a record 3,846 complaints through the fraud reporting hotline and web-based portal.
  • Increased the number of fraud investigations by 58 percent by collaborating with local partners to complete a record 16,870 investigations through the statewide Fraud Prevention and Investigation Program in 2016, up from 10,665 in 2015.
According to the governor, DHS provides almost $9 billion in benefits to more than 1.3 million people in Wisconsin annually.

Click here to read the full report. 

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