Medicaid’s program integrity staff are not recognized as employee of the year or case of the year but individuals with exemplary work can be nominated to receive a director’s award of excellence.

Idaho’s administrative rule IDAPA 16.05.07.205 states the Department may recoup the amount paid for items or services listed in Section 200 of these rules. In Section 200, it states the Department may deny payment for services not provided or not medically necessary, contrary to rules or provider agreement, or for failure to provide…

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Hi MaryKay – Idaho does not post the disclosures on the website.

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Idaho has a website that explains the process and provides an on-line form that can be used to self-report. Here’s the link:

https://healthandwelfare.idaho.gov/health-care-provider-self-report

Idaho currently has a RAC waiver.

Thanks, Melissa!

Does your state Medicaid program cover foot inserts for children? If so, what is the criteria for coverage? Idaho currently follows LCD A52481, which covers inserts only when the shoe is an integral part of a brace.

Cindy, these weren’t FFRs but we had some issues with final reports from Audit MIC final reports where we didn’t find the errors until the final reports were issued. We requested that known errors be corrected as required by generally accepted government audit standards. We spent the next 2 years arguing with CMS about the needed changes. CMS…

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Any states willing to share their processes for recovering outstanding Medicaid provider debts by having CMS withhold Medicare payment (42 CFR 405.377) or by using the Treasury Offset Program? Years ago, Robb Miller (CMS), suggested that states consider using the Treasury Offset Program instead of withholding Medicare payments. Anyone using…

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