Government

N.C. Medicaid creates new fraud unit

NEWS IN BRIEF — Posted Aug. 22, 2005

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To control escalating costs for the low-income insurance program, the state agency that runs North Carolina's Medicaid program in July created a 10-person task force to investigate fraud and abuse.

Members of the state's Division of Medical Assistance will comprise the task force, which will investigate potential abuses by visiting physician and other medical professional offices that accept Medicaid patients. The task force will determine what services and costs are reasonable and will take a tougher stance when it comes to dealing with suspected abusers while the state's attorney general's office investigates.

Allen Dobson, MD, the state's assistant secretary for health policy and medical assistance, said the state immediately would suspend Medicaid payments to physicians and others if an administrative review and hearing determines that there is fraud and abuse that should be referred to the attorney general's office. Also, those physicians and health professionals will not be allowed to accept new Medicaid patients.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/08/22/gvbf0822.htm.

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