Health and Human Services Commission Inspector General Stuart Bowen Jr. announced in his quarterly report a new initiative to help combat Medicaid fraud and also help Medicaid providers.
This is the IG Integrity Initiative. It was formally rolled out on April 21 before the Senate Committee on Health and Human Services.
Based upon community policing model
The rationale for the initiative is, per the quarterly report:
“Based on the community policing model, the new Initiative provides a framework for a paradigm shift in Medicaid oversight. It rests upon the core premise that the vast majority of Medicaid providers either comply with program rules or try to comply. These providers, along with the MCOs, want the same thing that the IG wants: the best Medicaid system Texas can have, with as little fraud, waste, and abuse as possible. Though most providers are law-abiding, a small cohort seeks to take advantage of the system for improper personal gain.
“The IG Integrity Initiative aims to partner with complying providers to identify and root out bad actors from the system. It fundamentally depends on partnerships that will generate an integrity network across Texas creating powerful links between the IG and all Initiative members. To become a member of the Initiative, a provider or MCO must:
- Publicly affirm integrity in its mission statement.
- Commit to reporting any and all fraud, waste, or abuse to the IG whenever and wherever they might find it.
- Provide Medicaid integrity training to their employees.
- Prominently post the IG’s Integrity Line poster in high-traffic areas.
- Provide a link to the IG’s website on their websites.”
Pledge form available
The pledge form can be downloaded from the IG website or viewed below.
The signed form is to be emailed to OIGIntegrityInitiative@hhsc.state.tx.us or mailed to:
Inspector General
IG Integrity Initiative
Texas Health and Human Services Commission
P.O. Box 85200
Austin, TX 78708-5200