In his recent quarterly report, Health and Human Services Commission Inspector General Stuart Bowen announced the kickoff off his initiative to increase awareness and cooperation on fraud, waste and abuse between Medicaid stakeholders.
The IG Integrity Initiative (IGII) is described as “a voluntary collaborative network that includes Managed Care Organizations, Dental Maintenance Organizations, Medicaid providers, associations, and any entity receiving Medicaid. The Initiative strengthens and enhances existing structures and standards that promote integrity within the system.”
To participate, potential members agree to:
- Incorporate integrity in their mission and values.
- Report all fraud, waste, and abuse to the IG whenever and wherever found.
- Train applicable staff on Medicaid integrity practices.
- Include a link to the IG’s website.
- Display the IG’s Integrity Line posters
Benefits of participation
As a benefit to participating in the IGII, the IG commits to working with members who choose to participate in the IG Integrity Initiative by:
- Establishing regular IGII meetings to enhance communication and understanding among all members.
- Working in conjunction with the Health and Human Services Commission’s Medicaid and CHIP Division to develop and disseminate training videos for members that provide guidance on best practices.
How to participate
The report doesn’t provide directions on how a provider can join. So we found out. This is how you do it.
- Go to the Inspector General website and its webpage about the IGII here. Read about the IGII.
- Download the IGII pledge form.
- Once the form is complete, email it back to OIGintegrityinitiative@hhsc.state.tx.us.
The IGII pledge
The IGII pledge consists of the following:
1) Our Mission or Values Statement communicates our commitment to integrity in our participation in the Texas Medicaid Program.
2) We reaffirm our commitment to report to the IG suspected Medicaid fraud, waste, or abuse whenever or wherever we encounter it.
3) We commit to training and supporting applicable staff regarding compliance with Texas Medicaid rules and regulations.
4) We commit to posting IG Integrity Line posters and to including a link on our website to the IG’s website.
The pledge form is simply signed and returned. No evidence of these points being in place is required.
Getting posters
We had no knowledge about the posters mentioned in #4 so contacted IG. We were told the following:
“The Integrity Line posters are being distributed by TMHP regional representatives. For Integrity Line participants, they will be delivered to the address submitted with their pledge form. Posters can also be requested through an email link that is on the Provider page on our website:
https://oig.hhsc.texas.gov/providers
“At the moment, we do not have the posters available to download, but we are considering that.”
Link to the website
Here is the link to the report form on the IG website – https://oig.hhsc.texas.gov/report-fraud.
Medicaid compliance training for staff
There are no parameters given for this so it is pretty vague what IG expects this training to consist of. We have sent an email to see if we can get this clarified.
UPDATE: Here is the response we received.
Regarding your email today about fraud, waste, and abuse training: right now, we have no specific requirement, so we are leaving it up to providers to determine what’s best for them. For now, we suggest using the FWA portion of the Medicaid training guide developed by TMHP. We are planning to add a training component to our website in the near future; when that gets going, we’ll let you know so you can pass it on to your contacts.