A Texas state Medicaid leader said her office is taking steps to address potential Medicaid fraud, following a letter from the governor pushing for stronger enforcement.
Last month, Gov. Greg Abbott directed state officials to investigate potential Medicaid fraud in Texas and implement additional anti-fraud measures, while recognizing low levels of fraud in the state’s program. The letter was addressed to the head of the Texas Health and Human Services Commission and the Health and Human Services Office of Inspector General.
Emily Zalkovsky, the state Medicaid director for the HHSC, said the letter asked the commission to conduct policy and service reviews for services that were identified as “more risky” at the federal level.
Medicaid fraud will not be addressed until prevention takes its rightful place along with investigation and recovery.
1) Incentives must be changed; right now, there are disincentives to reduce fraud
2) Measurements of success must be modified- prevention and cost reduction must be measured along with recovery.
3) Technology must be updated to deliver information outside of claims data and get verified data from the point of care