Testimony of 
Daniel R. Levinson, Inspector General 
U.S. Department of Health and Human Services 
_______________________________________________________________________________ 
Good Morning Mr. Chairman and Members of the Committee.  On behalf of the Office of 
Inspector General (OIG) at the U.S. Department of Health and Human Services (HHS), I would 
like to thank you for this opportunity to contribute to todays hearing on eliminating fraud in 
Medicaid.  I am accompanied by Michael E. Little, Deputy Inspector General for Investigations. 
 
My testimony highlights OIGs role under the Medicaid program integrity provisions of the 
recently enacted Deficit Reduction Act of 2005 (DRA); the program integrity responsibilities of 
the Centers for Medicare & Medicaid Services (CMS), the States, and OIG in overseeing 
Medicaid; and the increased use of Federal and State civil and administrative litigation cases to 
address Medicaid fraud and abuse.  I will close with a discussion of OIGs investigative priorities. 
 
The Federal Government pays a share, known as the Federal Medical Assistance Percentage 
(FMAP), of each States Medicaid costs.  Because Medicaid is a matching program, improper 
payments by States to providers virtually always result in corresponding improper Federal 
payments, whether payments for medical services or for administrative cost reimbursement.  The 
Federal share of Medicaid outlays is expected to exceed $192 billion in FY 2006 and could 
approach $200 billion in FY 2007.  Medicaid currently represents over 28 percent of the total 
budget of the U.S. Department of Health and Human Services.1          
 
MEDICAID INTEGRITY PROVISIONS IN THE 
DEFICIT REDUCTION ACT OF 2005, PUBLIC LAW 109-171 
 
The recently-enacted DRA includes several provisions that build on existing efforts to strengthen 
Medicaid program integrity.  The DRA includes the creation of a new Medicaid Integrity Program, 
which is modeled after the Medicare Integrity Program that was established by law a decade ago.  
The DRA also provides incentives for States to enact and enforce false claims acts; prohibits 
providers from billing Medicaid multiple times for the same drug; enhances third party liability 
enforcement; improves enrollment documentation requirements; and creates Medicaid 
transformation grants for States to use to adopt innovative cost-saving methods. 
 
The new Medicaid Integrity Program provides funding for the Secretary to enter into contracts 
with eligible entities to carry out Medicaid program integrity activities and also funds contracts to 
expand the Medicare-Medicaid Data Match Pilot Program (Medi-Medi program) that compares 
billings to both the Medicare and Medicaid programs by the same provider to identify aberrant 
patterns.  OIG welcomes the addition of new contracting entities to bolster Medicaid program 
integrity activities and Medi-Medi.  I will defer to CMS for a description of its plans for 
implementing and managing the program integrity contracts and for evaluating their contributions 
to the overall process. 
 
The DRA provides an additional Medicaid-specific funding stream for OIG, which will allow us to 
increase participation and exert leadership in a number of Medicaid integrity efforts.  In designing 
and implementing projects like Medi-Medi, CMS works with OIG, the Department of Justice 
                                                 
1 The HHS Budget in Brief estimates $199.3 billion (rounded) in Medicaid program outlays in FY 2007. 
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Senate Committee on Homeland Security and Governmental Affairs 
Subcommittee on Federal Financial Management, Government Information, and International Security 
Hearing:  March 28, 2006Page 1  (DOJ), and other oversight entities to ensure that such projects operate efficiently and effectively.  
As resources allow, OIG participates in various projects to identify areas of vulnerability, 
questionable provider billings, and patterns of abuse and neglect that are then formally 
investigated.  These projects include the use of data-mining, community outreach, and other 
quality of care monitoring tools. 
 
Under the DRA, we plan to dedicate more resources to the Medi-Medi project so that a full time 
OIG presence on the project might encourage further focusing of the data-mining and increase the 
number and quality of the cases that are referred by the project to law enforcement.  The targeted 
Medicaid resources in the DRA will increase OIGs ability to become a more active full-time 
participant and leader in this and similar Medicaid program integrity projects. 
 
The same is true of the quality of care initiative OIG jointly conducts with DOJ and others.  While 
our efforts to address failure of care cases are extensive, the targeted DRA resources will allow 
us to work even more closely with CMS, the State Survey and Certification teams, Medicaid Fraud 
Control Units (MFCUs), and the State Long Term Care Ombudsmen to identify entities where 
there appears to be abuse and neglect of such a nature as to justify further investigation.  OIG 
works with Federal prosecutors, the FBI, and State and local law enforcement agencies to conduct 
investigations into these matters and remedy the wrongdoing. 
 
Further, DRA resources will allow OIG to continue its work with the National Association of 
Medicaid Fraud Control Units (NAMFCU), MFCUs, and State Medicaid Agencies (State 
Agencies) to conduct training to better enable program administrators and claims examiners to 
identify questionable billing practices earlier and more effectively.  Such training is designed to 
assist agencies in gathering the information that is needed by investigators and prosecutors to 
successfully prosecute these cases.   
 
FEDERAL AND STATE ROLES AND RESPONSIBILITIES 
 
In 1977, Public Law 95-142 (the Medicare-Medicaid Antifraud and Abuse Amendments of 1977) 
was enacted to strengthen the capability of the Government to detect and prosecute fraudulent 
activities under the Medicare and Medicaid programs.  CMS has a key role in Medicaid program 
integrity as the Federal program manager, and the State Agencies and MFCUs are responsible for 
protecting the integrity of the Medicaid program.  State Agencies and MFCUs each perform 
unique roles in carrying out program integrity activities.  OIGs authorities with regard to all of the 
Departments programs to prevent and detect waste, fraud, and abuse, and to promote economy, 
efficiency, and effectiveness apply fully to Medicaid. 
 
CMS Responsibilities 
CMS is responsible for overseeing each States comprehensive State Medicaid Plan to ensure State 
compliance with Federal laws, regulations, and departmental policies, including the detection, 
development, and referral of suspected fraud cases.  CMS is required to review State Agency 
performance through onsite reviews and examination of individual case records.2  In 1996, CMS 
established a program integrity group to address fraud and abuse issues within the Medicare and 
Medicaid programs.  This group conducts and oversees many projects that are intended to reduce 
program fraud.    
                                                 
2 42 CFR  430.32(a). 
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Senate Committee on Homeland Security and Governmental Affairs 
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Hearing:  March 28, 2006Page 2   
State Agency Responsibilities 
State Agencies are responsible for establishing policies, computer systems and edits to process 
Medicaid claims and for conducting analyses of providers patterns of practice (data-mining).  
Federal regulations require State Agencies to conduct preliminary investigations when they 
identify questionable practices or receive complaints of suspected Medicaid fraud or abuse.3  When 
the results of a preliminary investigation give a State Agency reason to believe that fraud has 
occurred, typically it must refer the matter to the States MFCU for investigation.4  Overpayments 
that are not the result of fraud generally remain in a State Agencys jurisdiction for collection. 
 
To accomplish these tasks, State Agencies must have certain information processing systems, 
including a Medicaid Management Information System and a Surveillance and Utilization Review 
Subsystem (SURS).5  Automated mechanized claims processing and information retrieval systems 
are used not only to process Medicaid claims for medical services, but also are used by the SURS 
staff to retrieve and produce service utilization and management information for program 
administration and audit purposes.   
 
States establish various structures to carry out program integrity functions.  Some State Agencies 
exclusively use staff within the SURS unit to conduct required analyses, while others have 
established comprehensive program integrity or Inspector General units to oversee these functions.  
In smaller States, the SURS units may operate the program integrity units, conducting preliminary 
reviews of potential Medicaid fraud or abuse and referring appropriate cases for full investigations.   
 
In all States, the SURS units apply automated post-payment screens to Medicaid claims to identify 
aberrant billing patterns that may indicate fraud or abuse.  When potential fraud cases are detected, 
the State Agency is required to refer the cases to the States MFCU.  Despite SURS being an 
important detection mechanism, OIG has found that the quality and quantity of referrals need 
improvement in many States.  However, OIG has also observed that positive interagency and staff 
relationships between State Agencies and their respective MFCUs tend to contribute to successful 
referrals and resolution of fraud.  
 
Medicaid Fraud Control Unit Responsibilities 
MFCUs are responsible for investigating and prosecuting provider fraud and patient abuse and 
neglect.6  They integrate the skills of criminal investigators, attorneys, and auditors to carry out 
their mission.  Section 1903(q)(6) of the Social Security Act requires that MFCUs be composed of 
at least one investigator, one attorney, and one auditor.7  MFCUs must be single identifiable 
entities of the State government and certified annually by OIG as meeting Federal requirements, 
including location within State government, staffing, roles, and responsibilities.8  MFCUs receive 
at least 75 percent of their funding from a Federal grant managed by OIG.  Forty-eight States and 
the District of Columbia have established MFCUs.9  Most MFCUs are located within the State 
Attorney Generals office.     
                                                 
3 42 CFR  455.14. 
4 42 CFR  455.15. 
5 42 CFR  456.3. 
6 Social Security Act,  1903(q)(3). 
7 See also 42 CFR  1007.13. 
8 42 CFR  1007.15. 
9 North Dakota and Idaho have not established MFCUs, and, in these two States, the State Agency is responsible for conducting 
investigations and referring cases to State or local prosecutors.   
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Senate Committee on Homeland Security and Governmental Affairs 
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Hearing:  March 28, 2006Page 3   
Under a 1999 amendment to the MFCU statute, the jurisdiction of the MFCUs was expanded to 
allow them to investigate and prosecute Medicare or other health care fraud, in addition to 
Medicaid, if the following conditions are met:  (1) the OIG of the relevant Federal agency (such as 
HHS OIG for the Medicare program) approves the case, and (2) the suspected fraud or violation 
of law primarily concerns Medicaid, i.e., the Medicare and other health care fraud allegation is a 
part of a case that is primarily a Medicaid fraud case.  The same statutory amendment also 
authorized MFCUs to investigate patient abuse and neglect in non-Medicaid board and care 
facilities. 
 
In addition to receiving referrals of allegations from the State Agencies, MFCUs receive leads 
from other sources, including other State and Federal law enforcement agencies, whistleblowers, 
beneficiaries, concerned citizens, the press, and legislative bodies.  If a matter referred to a MFCU 
is determined to involve an improper payment that does not warrant a fraud investigation, the 
matter is referred to the State Medicaid agency to pursue recovery of the improperly paid amount.  
Otherwise, the MFCU fully investigates and ensures appropriate resolution, including prosecution.  
Outcomes may include convictions, restitution, fines, penalties, or corporate integrity agreements, 
as well as incarceration. 
 
The following chart shows MFCUs funding and statistical accomplishments for the past 10 years.  
The Federal/State investigative receivables include settlements or court-ordered restitution, fines, 
and penalties.   
 
Medicaid Fraud Control Units 
Federal Expenditures and Related Federal/State Statistical Accomplishments 
 
Federal  Federal/State
Year   Grants*  Receivables   Convictions  
2005  $144,330,097 $709,619,411 1,123 
2004  131,086,294 572,585,322 1,160 
2003  119,831,000 268,481,661 1,096 
2002  116,979,079 288,315,524 1,147 
2001   106,699,505  252,585,423  1,002  
2000   95,979,000  180,941,872  970  
1999   89,703,745  88,738,327  886  
1998   85,793,887  83,625,633  937  
1997   80,557,146  147,642,299  871  
1996   77,453,688  57,347,248  753  
* Amount awarded to MFCUs. 
 
This chart provides a rough measurement of MFCU accomplishments and does not reflect the 
responsibilities MFCUs have for investigating patient abuse and neglect in Medicaid-funded 
facilities and in board and care facilities.  In most instances, these cases do not generate monetary 
returns, but are critical to the provision of high quality and appropriate care, especially for our 
Nations frail elderly.  Later in my testimony, I will describe nursing home quality of care, which 
includes patient abuse, as a priority concern of OIG as well.   
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Senate Committee on Homeland Security and Governmental Affairs 
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Hearing:  March 28, 2006Page 4   
OIG Responsibilities 
Protecting the integrity of all HHS programs is at the core of OIGs mission.  Accordingly, OIG 
initiates audits, evaluations, and investigations of the expenditure of Medicaid dollars and the 
operation of the Medicaid program as appropriate.  We have developed good working relationships 
with the agencies responsible for identifying, preventing, and curbing fraud in Medicaid.  In 
addition to CMS, the State Agencies, and MFCUs, OIG partners with the NAMFCU, State and 
local law enforcement, the HHS Administration on Aging, State Long Term Care Ombudsmen, the 
FBI, and DOJ. 
 
Currently, approximately 23 percent of OIGs resources under the Health Care Fraud and Abuse 
Control account are focused on Medicaid matters.  With regard to our investigative work, many of 
these matters are investigated jointly with MFCUs and/or the FBI.  By working with these 
agencies to identify questionable provider billings, we maximize the impact of the resources 
available and focus on the providers that are causing the most harm to the program and to its 
beneficiaries.  The structure of these relationships is different in each State because the Medicaid 
program structure is unique to each State.  
 
OIGs Role in State Medicaid Audit Partnerships 
One of OIGs major outreach initiatives has been to work more closely with State auditors in 
reviewing the Medicaid program.  To this end, a partnership plan was developed to foster joint 
reviews and provide broader coverage of the Medicaid program.  The partnership approach has 
proven an overwhelming success in ensuring more effective use of scarce audit resources by both 
the Federal and the State audit sectors.  To date, partnerships on such issues as prescription drugs, 
clinical laboratory services, the drug rebate program, school-based services, durable medical 
equipment, hospital transfers and transportation have been developed in 25 States.  Reports have 
resulted in identification of more than $262 million in Federal and State savings and have led to 
joint recommendations for savings at the Federal and State levels, as well as improvements in 
internal controls and computer system operations.  
 
OIGs Role in Identifying Improper Payments 
Improper or fraudulent payments result in a substantial drain on State and Federal funds.  
Therefore, OIG directly conducts a large number of Medicaid audits and evaluations on our own 
initiative or at the request of CMS, the Department, or Congress.  Intended to identify improper 
payments, these audits and evaluations not only reveal questionable billings, but sometimes also 
expose fraud, program management deficiencies, weaknesses, and loopholes in program rules.  
When we question Medicaid payments, we notify CMS of our findings, and, if CMS agrees that 
the questioned payments were improper, it seeks to recover the Federal share from the States.  If 
possible fraud is found, our investigators review the matter and determine whether to open an 
investigation.  Our auditors may also assist in the ongoing investigations being conducted by our 
office or other law enforcement agencies. 
 
OIGs Oversight of MFCUs 
In addition to OIGs general Medicaid oversight work, as mentioned previously, the Secretary 
delegated to OIG the responsibility for administering grants to fund MFCUs ongoing operations.  
The States are reimbursed for the operation of MFCUs at a rate of 90 percent of costs for the first 
3 years after the Units initial certification by OIG and 75 percent thereafter.  Thus far in FY 2006, 
OIG has awarded approximately $159.1 million in grant funds to MFCUs. 
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Senate Committee on Homeland Security and Governmental Affairs 
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Hearing:  March 28, 2006Page 5   
OIGs responsibilities for oversight of the funding and operation standards of MFCUs include 
monitoring their overall performance and productivity and ensuring that they devote their full-time 
efforts to Medicaid-covered health care fraud and patient abuse.  Our oversight also includes 
responsibility for the initial certification and yearly recertification of MFCUs.  Regulations require 
MFCUs to submit an application to our office with an annual report and a budget request.  The 
MFCUs applications, annual reports, and budget requests are reviewed to determine if they are in 
conformance with performance standards that were developed jointly by OIG and MFCUs.  OIG 
also relies on feedback from the State Agency and OIGs Office of Investigations field offices to 
assess MFCUs performance.  OIG staff are now conducting between 8 and 14 on-site reviews 
annually.  We maintain ongoing communication related to the interpretation of program 
regulations and other policy issues with individual State MFCUs and NAMFCU.  
 
For example, OIG works with NAMFCU to train MFCUs on the importance and effectiveness of 
using the exclusion process to ban problem providers from participating in Federal and State health 
care programs.  In addition to providing speakers at NAMFCUs annual conferences, OIG staff 
routinely conduct outreach and training with individual State Agencies and MFCUs, as well as 
licensing boards and State and local prosecutors, to establish case referral processes and to develop 
the working relationships that will allow potential exclusion matters to reach OIG. 
 
Our office, MFCUs, and other law enforcement agencies work closely together on fraud cases and 
other activities, and these partnerships have greatly enhanced OIGs ability to carry out our 
mission.  Generally, the MFCUs focus on Medicaid fraud, and OIGs investigators focus on 
Medicare fraud.  However, many providers who are involved in illegal activities are found to be 
defrauding both programs at the same time.  Therefore, an investigation of either program may 
reveal fraud in the other program as well.  In FY 2005, OIG conducted joint investigations with 
MFCUs on 331 criminal cases and 95 civil cases and achieved 54 convictions and 28 settlements 
or judgments in civil cases. 
 
FEDERAL AND STATE CIVIL LITIGATION INVOLVING MEDICAID 
 
OIG, along with DOJ and other Federal law enforcement agencies, has achieved major successes 
in using the civil False Claims Act, and in particular its qui tam10 provisions, in pursuing fraud in 
both the Medicare and Medicaid programs.  Many major cases have been brought against 
pharmaceutical manufacturers in particular. 
 
States are increasing their own efforts in civil litigation.  The amount of civil recoveries by 
MFCUs has been increasing in recent years.  Under a 1999 policy interpretation by OIG, MFCUs 
are expected to investigate any potential criminal violations and must then consider if there is a 
civil fraud case.  Civil fraud cases may be pursued under State laws, including false claims acts in 
those States that have such laws, or under the Federal civil False Claims Act, which has been a 
longstanding and powerful tool in the fight against health care fraud and abuse.  Under the False 
Claims Act, DOJ may seek penalties and damages.  Under our own administrative sanction 
                                                 
10  The qui tam provisions allow whistleblowers to bring suit under the civil False Claims Act seeking recoveries 
against defrauders of government programs.  DOJ, with input from OIG, determines whether or not to intervene in the 
case; the case may proceed without DOJ.  In either case, the whistleblower, or relator, may share in any later 
recoveries, whether ordered by a court or as the result of a settlement. 
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Senate Committee on Homeland Security and Governmental Affairs 
Subcommittee on Federal Financial Management, Government Information, and International Security 
Hearing:  March 28, 2006Page 6  authorities, OIG may impose civil monetary penalties and exclude providers for violations of 
Federal health care laws. 
 
The DRA specifies that OIG, in consultation with the Attorney General, will review State laws 
relating to false and fraudulent claims to determine that the laws (1) establish liability to the State 
for false or fraudulent claims described in the Federal False Claims Act with respect to Medicaid 
expenditures; (2) contain provisions that are at least as effective in rewarding and facilitating qui 
tam actions as those in the Federal False Claims Act; (3) contain a requirement for filing an action 
under seal for 60 days with review by the State Attorney General; and (4) contain a civil penalty 
that is not less than the amount authorized by the Federal False Claims Act.  If a State has in effect 
a law relating to false or fraudulent claims that meets Federal requirements, the State is entitled to 
a greater share of the recoveries in any action brought under such a law.  This provision is effective 
January 1, 2007. 
 
The DRA requires certain Medicaid providers to educate their employees about false claims 
recoveries.  Entities meeting certain criteria are required, as a condition of receiving Medicaid 
payments, to establish written policies, procedures, and protocols for training all employees, 
contractors, or agents of the entity.  This training must include a detailed discussion of the Federal 
False Claims Act, Federal administrative remedies for false claims and statements, any State laws 
pertaining to civil or criminal penalties for false claims and statements, and whistleblower 
protections under such laws.  We anticipate that this employee education will result in better 
awareness of fraud in the work place and may help prevent fraud and abuse of the Federal health 
care programs.  
 
OIGS INVESTIGATIVE PRIORITIES 
 
OIGs criminal investigations and related activities supplement MFCUs efforts to curb Medicaid 
fraud.  In the current and coming fiscal year, OIGs antifraud priorities in Medicaid will include: 
 
  working more closely with MFCUs and CMS in the States that participate in Medi-Medi 
projects;   
  focusing on areas of the Medicaid program that are known to be vulnerable in the Medicare 
arena;  
  working with MFCUs and State Agencies to identify patterns of potential fraud; 
  initiating projects that cross State and program linessuch as reviewing billing data from 
providers that bill more than one State or that bill both Medicare and Medicaid (outside the 
Medi-Medi project States) to determine if the volume of claims reveals the potential for 
false billing; 
  continuing to expand our work on quality of care;   
  partnering with MFCUs, the State Survey and Certification teams, DOJ, and State 
prosecutors to bring to justice those providers who abuse this vulnerable population; 
  supporting outreach and education efforts to MFCUs, Attorneys General Offices and 
licensing boards to refer matters to OIG for exclusion action. 
 
OIG has historically focused on three Medicaid program vulnerabilities:  nursing home quality of 
care, pharmaceutical manufacturer fraud, and drug diversion.  These areas continue to be 
investigative priorities for our office. 
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Senate Committee on Homeland Security and Governmental Affairs 
Subcommittee on Federal Financial Management, Government Information, and International Security 
Hearing:  March 28, 2006Page 7   
Nursing home quality of care.  Matters for which OIG initiates quality of care investigations 
include patient abuse, neglect, and deaths.  While such cases are usually pursued by MFCUs under 
State laws, OIG typically becomes involved when there is either a pattern of abuse and neglect or 
egregious single instances.  At the Federal level, remedies under the False Claims Act are available 
if the investigation demonstrates that a nursing home (its staff and/or its administrator) provided to 
Medicaid residents services that were so poor as to constitute billing for services not rendered.  
Claims or cost reports may also be considered false if the nursing home does not provide the level 
of care or the number of staff as reported on the cost report.  Abuse may also be considered a 
criminal case on the Federal level if the investigation reveals the submission of false adverse event 
reports, for example, if a patient was reported to have fallen but was, in fact, abused. 
 
In one example, OIG investigated and participated in the prosecution of a matter that led to Federal 
indictments of a nursing facility and its administrators on local and Federal charges involving the 
death of a resident.  The resident, a person with Alzheimers Disease who needed supervision, 
wandered out of the nursing home and froze to death.  Prior to reporting the death, employees of 
the nursing home brought her body back into the home, dressed her, put her into a bed, and 
reported to the family that the woman had died of natural causes while asleep.  The defendants 
were convicted of the Federal charges of health care fraud and making false statements; they are 
awaiting sentencing.  The State trial is set to convene in late April, with one of the subjects facing 
involuntary manslaughter charges. 
 
Pharmaceutical manufacturer fraud.  These investigations often involve the price of the drugs as 
set and reported by the manufacturers.  Medicaid reimbursement of drugs is often based on the 
Average Wholesale Price (AWP) of the drug as reported by the manufacturers.  OIG has found that 
companies report AWPs that often far exceed actual acquisition costs, resulting in inflated 
payments made by the Medicaid programs.  There are also fraudulent practices relating to 
misreporting and underpaying of the Medicaid rebates for drugs and the promotion of drugs for 
non-FDA approved uses.  OIG also investigates kickbacks paid to prescribing physicians and 
others for drugs covered by the Medicaid program.  Often the damages associated with this 
conduct are substantial.  For example, in 2001 a pharmaceutical manufacturer entered into a global 
settlement to resolve its criminal, civil, and administrative liability for sales, marketing, and 
pricing practices.  The total settlement amount in that case was $875 million in payment to the 
Federal and State governments.  More recently, in 2004 and 2005, other pharmaceutical 
manufacturers settled large fraud cases involving Federal health care and other programs, 
including Medicaid.  Through these settlements, pharmaceutical manufacturers agreed to pay more 
than $523 million to the States for Medicaid-related issues. 
 
Drug diversion.  OIG conducts many investigations involving Medicaid prescription drug fraud 
issues in addition to pricing.  These casesmany of which involve prescription pain medications 
such as oxycontinfocus on the following providers:  physicians who unnecessarily prescribe 
these drugs in exchange for cash or in-kind kickbacks; physicians who buy back and either self 
medicate or sell the diverted drugs; and pharmacists who are in collusion with the doctors or with 
the beneficiaries.  In such fraudulent schemes, the pharmacists buy back and resell the drugs, agree 
to fill prescriptions in exchange for kickbacks from physicians, short the amount of the drug 
provided and then sell the excess pills, or pay kickbacks to doctors for referring the patients to 
them.  The Medicaid program, which pays for the drugs, and Medicaid beneficiaries are both 
victims of these schemes.  These matters are worked jointly with the Drug Enforcement 
__________________________________________________________________________________________ 
Senate Committee on Homeland Security and Governmental Affairs 
Subcommittee on Federal Financial Management, Government Information, and International Security 
Hearing:  March 28, 2006Page 8  Administration, MFCUs, local law enforcement, and FBI and are prosecuted at both the Federal 
and State levels. 
 
CONCLUSION 
 
In conclusion, Mr. Chairman, thanks to the targeted funding provided by DRA, OIG will continue 
to devote substantial resources to auditing, evaluating, investigating, and prosecuting abuses in the 
Medicaid program.  OIG identifies payment issues and errors, uncovers program vulnerabilities, 
recommends improvements to the program, and, when necessary, pursues appropriate law 
enforcement actions to recover funds paid to fraudulent providers.  OIG will also continue to 
collaborate with CMS, State auditors, MFCUs, DOJ, and other government enforcement agencies 
to identify, prevent, and deter fraud and abuse.  The management and fiscal integrity of Medicaid 
is a top priority for OIG.  I appreciate this opportunity to testify, and I welcome your questions. 
 
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Senate Committee on Homeland Security and Governmental Affairs 
Subcommittee on Federal Financial Management, Government Information, and International Security 
Hearing:  March 28, 2006Page 9