Office of Program Policy Analysis and Government Accountability
Office of Program Policy Analysis and Government Accountability

Enhanced Detection and Stronger Use of Sanctions Could Improve AHCA's Ability to Detect and Deter Overpayments to Providers

Report 06-23, March 2006




Report Summary

Since our 2004 review, the Agency for Health Care Administration (AHCA) has worked to implement legislative actions to safeguard the state against waste, abuse, and fraud in the Medicaid program. Although these actions are beneficial, AHCA has not yet fully implemented all prior OPPAGA recommendations related to performance measures and detection efforts. In addition, AHCA should consider strengthening its sanctioning process to ensure that it deters providers from repeating abusive billing patterns, and expand oversight of Medicaid managed care to prevent and reduce waste, abuse, and fraud in managed care plans


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Copies of this report in print or alternate accessible format may be obtained by email OPPAGA@oppaga.fl.gov, telephone (850) 488-0021, or mail 111 W. Madison St., Room 312 Tallahassee, FL 32399-1475.
Copies of this report in print or alternate accessible format may be obtained by email OPPAGA@oppaga.fl.gov, telephone (850) 488-0021, or mail 111 W. Madison St., Room 312 Tallahassee, FL 32399-1475.
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