Always Reppin’ – Region VIII

Gene Cottrell (UT)

Leveraging Resources

Fraud, abuse and waste is not going away. As those who commit fraud become more sophisticated, we,
fraud fighters have to learn to leverage every anti-fraud resource available to us.

Region 8 monthly meetings became a valuable resource over the past year as we shared what resources
we incorporate into our anti-fraud work. One thing we’ve discovered is sometimes those resources that
don’t appear valuable at first glance do offer value when wrapped into an overarching strategy. Regional
meetings offer us an opportunity to share new resources, how our individual states incorporate those
resources and concerns we may harbor regarding those resources. Our management teams are then
much better informed and are able to apply available resources in our fight against fraud.

States with few resources can, and should, leverage resources such as NAMPI, UPIC Contractors, HFPP,
and the myriad of other available resources in this fight. Our collective vision, although lofty, should be a
Medicaid system free of fraud, abuse and waste where every taxpayer dollar is used efficiently in the
care of our vulnerable citizens. Leveraging available resources helps realize that vision.

As an example, over the past year, more states within Region 8 began using our UPIC contractors. States
who were already using the UPIC willingly shared how they are using the contractors, what works best in
practice and what doesn’t, and what items to include or not include in the agreements with the
contractors prior to entering into the agreements. We held similar discussions regarding HFPP and how
to use the studies they produce.

For some larger states, this may seem insignificant, but Region 8 is comprised of all small state Medicaid
programs with limited Program Integrity resources. Some of our PI sections only having a couple of
employees within their sections. The ability to expand our reach through the use of these types of
resources is invaluable.

We encourage all PI partners to take advantage of these types of resources, but more importantly to
expand the conversation about what works and what doesn’t as you glean lessons learned. Small states
are watching and learning and we appreciate all the advice we receive as we strive to achieve our vision.

Find your regional representative here.