Medical providers banned from a Medicaid program in one state are able to participate in another state’s program, flouting regulations that are designed to stop such practices.
A study by the U.S. Department of Health and Human Services Office of the Inspector General (OIG) found that about half of the states were unable to terminate improperly enrolled providers that were part of privately run Medicaid managed-care programs.
The report from the federal auditor found that of the 1,539 healthcare providers terminated by a state in 2011, 295 of them still participated in another state’s Medicaid program. It also found that Medicaid provided $7.4 million to 94 providers for services after their termination.
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