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Medicaid directors want better anti-fraud teamwork

NEWS IN BRIEF — Posted Nov. 5, 2012

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Improved state-federal collaboration would strengthen Medicaid program integrity efforts, the National Assn. of Medicaid Directors wrote in an Oct. 5 letter to Marilyn Tavenner, acting administrator for the Centers for Medicare & Medicaid Services.

The letter discussed NAMD’s concerns that communication problems between CMS and the states were undermining the success of anti-fraud efforts. One example given was the fact that the Dept. of Health and Human Services, in launching a public-private effort to crack down on health care fraud, failed to consult with state Medicaid programs on the planning and launch of the partnership.

“States and the federal government must work together to build a robust program integrity framework that includes Medicaid,” the letter said. In a March report, NAMD issued a series of recommendations on how to improve Medicaid program integrity initiatives, such as clarifying federal and state responsibilities, and improving communication and collaboration between federal and state entities on these types of initiatives.

In the letter, NAMD asked for CMS guidance on making specific improvements to program integrity efforts, such as working with states to develop a screening and verification program for health care professionals “built on a collaborative structure that shares information and avoids duplication.”

Note: This item originally appeared at http://www.ama-assn.org/amednews/2012/11/05/gvbf1105.htm.

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