Contract and Policy Changes and General Future Expectations.

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Presentation transcript:

Contract and Policy Changes and General Future Expectations

Investigations vs reviews Audits vs Investigations Data Mining Activities Recoupments Dependency vs Interdependency Task Force Oversight - Metrics

OIG PI Audits Data Analytics Recoupments MCOs PI Audits Data Analytics Track, Trend, Report Periodic Data Mining-Outliers OIG and MCOs Track, Trend, Analyze

Correct issues in policy Findings to feed system Detect, Investigate provider fraud Consistency in guidance to MCOs MCOs correct issues internally Prevent future occurrences