Report No. 2011-37
July 2011
Complete Report
Findings in the audit of the Office of Attorney General, Medicaid Fraud Control Unit
Background
The Medicaid Fraud Control Unit was created in 1994. It investigates and prosecutes Medicaid fraud by health care providers and reviews complaints of abuse or neglect of nursing home residents. Section 191.909.1, RSMo, requires the Attorney General's office to annually report certain activities related to the Medicaid Fraud Control Unit.
Audit Findings
The state auditor is required to conduct an audit to determine the amount of money invested in the unit and the amount of money actually received by the unit. The scope of our audit included, but was not necessarily limited to, the 2 years ended December 31, 2010. The Medicaid Fraud Control Unit collected almost $39 million and $80 million in 2010 and 2009, respectively. No findings resulted from our audit.
In the areas audited, the overall performance of this entity was Excellent.*
American Recovery and Reinvestment Act 2009 (Federal Stimulus)
The Medicaid Fraud Control Unit did not receive any federal stimulus monies during the audited time period.
*The rating(s) cover only audited areas and do not reflect an opinion on the overall operation of the entity. Within that context, the rating scale indicates the following:
Excellent:
The audit results indicate this entity is very well managed. The report contains no findings. In addition, if applicable, prior recommendations have been implemented.
Good:
The audit results indicate this entity is well managed. The report contains few findings, and the entity has indicated most or all recommendations have already been, or will be, implemented. In addition, if applicable, many of the prior recommendations have been implemented.
Fair:
The audit results indicate this entity needs to improve operations in several areas. The report contains several findings, or one or more findings that require management's immediate attention, and/or the entity has indicated several recommendations will not be implemented. In addition, if applicable, several prior recommendations have not been implemented.
Poor:
The audit results indicate this entity needs to significantly improve operations. The report contains numerous findings that require management's immediate attention, and/or the entity has indicated most recommendations will not be implemented. In addition, if applicable, most prior recommendations have not been implemented.
Complete Audit Report
Missouri State Auditor's Office
moaudit@auditor.mo.gov
