Medicaid Enforcement Priorities — Insights From the Illinois Inspector General

One of the most important issues facing providers today is Medicaid compliance and enforcement. As part of the Deficit Reduction Act of 2005, the U.S. Congress created the Medicaid Integrity Program, which generates substantial increases in federal funding and oversight of state Medicaid programs. This groundbreaking federal law also provides financial incentives designed to encourage states to dramatically increase Medicaid integrity initiatives and Medicaid enforcement proceedings. Medicaid enforcement in Illinois is robust and, given the recent federal emphasis on Medicaid program integrity, promises to remain a top priority.

During this Foley Executive Briefing Series program, John C. Allen, IV, Inspector General of the Illinois Department of Healthcare and Family Services, discussed the office’s Medicaid enforcement priorities, including a new diagnosis-related group (DRG) audit program for inpatient hospital services. Joining Mr. Allen was Foley attorneys Janice A. Anderson and Daniel S. Reinberg, who offered providers strategies for ensuring they are in compliance with Medicaid regulations as well as tips for making an effective voluntary disclosure to the Office of the Illinois Inspector General.

For further information, please contact Maura Lopez at [email protected] or 619.685.6422.

Medicaid Enforcement Priorities — Insights From the Illinois Inspector General is part of the Foley Executive Briefing Series. Learn more about upcoming programs in the series at Foley.com/FEBS.