The HHS’ Office of Inspector General released a report this past Monday indicating that a number of states providing services to Medicaid beneficiaries enrolled in managed care are not complying with the mandatory quarterly reporting requirements.  In response to this study, the OIG recommended that the Center for Medicare and Medicaid Services use its authority to begin withholding federal funds from non-compliant states citing that the data is crucial to Medicaid oversight and the prevention of fraud and abuse.  Although states struggle with capturing the level of quality data needed to complete the reporting requirements, CMS continues to make enforcement a priority.  In response to the report, CMS indicated that it has already issued a notice of proposed rulemaking that would allow for the withholding of federal funds.  For those states who lack the ability to capture the data whether through lack of technological infrastructure or other reasons, this latest policy does not bode well.  For more information, go to: http://www.modernhealthcare.com/article/20150706/NEWS/150709966/not-all-states-reporting-required-medicaid-data-oig-says.

Written by: Traci S. Thompson