State Member Fritz Jenkins
State Member-
Fritz Jenkins replied to the discussion Administrative terminations for criminal acts not involving Medicaid in the forum State Only Forum a year ago
Reply to Administrative terminations for criminal acts not involving Medicaid
From Oregon: OAR 410-120-1400
https://secure.sos.state.or.us/oard/viewSingleRule.action?ruleVrsnRsn=306658
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Fritz Jenkins replied to the discussion MFCU Questions in the forum State Only Forum 2 years ago
From Oregon:
- How do you get your referrals to
your MFCU (not so much the mechanics but, rather, whether you send them
for them to review, you meet and discuss first, whether before the
referral there is any collaboration?
Generally, we send via email with full summary and back up documentation. Higher level/priority cases…
- How do you get your referrals to
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Fritz Jenkins started the discussion New York Times article: beneficiary billing in the forum State Only Forum 2 years ago
New York Times article: beneficiary billing
I am wondering if other states are looking into the national attention brought to light by a NYT article, (link: New
York Times Article), around Providence Health and Services system billing Medicaid members for Medicaid covered services. In Oregon, we are in communication with Providence, requesting the pertinent data from them to assess… -
Fritz Jenkins replied to the discussion CMS Eligibility Contact in the forum State Only Forum 2 years ago
Reply to CMS Eligibility Contact
I agree we need the clarity. What we find in Oregon is when a beneficiary commits fraud to obtain services, it is referred to local law enforcement as a “theft of services.” However, local law enforcement rarely takes the case and the provider is left without any support. The beneficiary walks with no consequence, only to continue to commit the fraud.
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Fritz Jenkins replied to the discussion Civil case settlements in the forum State Only Forum 3 years ago
Reply to Civil case settlements
Dawn–as the Medicaid agency, we received the check from MFCU for the total amount (state and federal share). We have financial coding that is applied to the check and it routes the money appropriately. Our 64 accountant picks up the info from the coding and gets it on the 64 correctly. The state Medicaid is first made whole with the recovery.…
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Fritz Jenkins replied to the discussion MCO Contracts and Program Integrity in the forum State Only Forum 3 years ago
Reply to MCO Contracts and Program Integrity
Here you go from Oregon…this is the 2022 contract.
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Fritz Jenkins started the discussion Posting Final Audits in the forum State Only Forum 3 years ago
Folks,
Would like to know if your state publicly posts your final audits. Do you post them before or after all appeals are exhausted? And if you post, where?
Thank you all!
Fritz
