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Audits Children's Health Insurance Program (CHIP)

King & Spalding

CMS Paid Over $277 Million in Unallowable Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Bonus Payments...

King & Spalding on

On September 19, 2019, the OIG released a report relating to recent audits of the CHIPRA program. The audits, performed from April 2012 through September 2017, identified over $277 million in unallowable payments made to 12...more

Epstein Becker & Green

New Audits and Penalties on Medicaid Plans and Providers Related to Encounter Data in Value-Based Payment Models

Epstein Becker & Green on

For value-based payments, encounter data[1] provides valuable information in much the same way that claims data does for fee-for-service arrangements. With the growing prevalence of value-based payments, especially in the...more

Clark Hill PLC

Texas OIG Turns Over New Leaf: MCOs Must Turn Attention to SIUs

Clark Hill PLC on

More active SIUs may mean more scrutiny of Medicaid providers - The Texas Office of Inspector General (OIG) has just completed its first full year of reforms under a new Inspector General. 2017 may reveal whether these...more

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