(COLUMBUS, Ohio) - Today Ohio Attorney General Mike DeWine announced that the Ash Center for Democratic Governance and Innovation at Harvard University's John F. Kennedy School of Government honored the Ohio Program Integrity Group (PIG) as one of its top "Bright Ideas" for 2012. Award winners were chosen based on their ability to demonstrate a creative range of solutions to issues such as rural degradation, environmental problems, and crime.
Ohio's PIG program brings together representatives from several state agencies with complementary program integrity responsibilities, including the Attorney General's Medicaid Fraud Control Unit, to craft data mining algorithms designed to identify fraudulent Medicaid providers and to plan a coordinated response to these findings.
"For many years, waiting for allegations of fraud was the only way an investigation would begin," said Ohio Attorney General Mike DeWine. "Waiting for reports potentially leaves hundreds of cases of fraud unreported and millions of taxpayer dollars in the pockets of criminals. The Program Integrity Group uses proactive methods to stop these crimes as soon as possible."
In order to quickly identify Medicaid fraud, the group developed sophisticated search criteria that are applied to paid Medicaid claims. When a provider triggers the search criteria, the information is scrutinized and examined for possible fraudulent activity. The participating agencies then share the information and decide which agency is best positioned to handle the investigation.
Medicaid fraud is estimated to cost American taxpayers $9.5 billion each year. These advanced investigative techniques are one of the reasons Ohio's Medicaid Fraud Control Unit was named the number one unit of its kind in the nation by the U.S. Department of Health and Human Services in 2011.
The Ohio PIG is comprised of representatives of state agencies responsible for different aspects of the Medicaid program including the Ohio Attorney General's Office Medicaid Fraud Control Unit; the Ohio Department of Job and Family Services' Office of Ohio Health Plans and Surveillance and Utilization Review Section; the state's Recovery Audit Contractor; the Ohio Auditor of State's Medicaid Contract Audit Section; and the Medicare Program Safeguard Contractor/Zone Program Integrity Contractor.
Anyone who suspects Medicaid fraud can contact Attorney General DeWine's office at 800-282-0515 or www.OhioAttorneyGeneral.gov.
Media Contacts:
Dan Tierney: 614-466-3840
Jill Del Greco - 614-466-3840