State Auditor Says State's Medicaid Fraud Detection Inadequate
Department for Disability Determination Services Does Little to Proactively Identify Fraud
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Edward B. Hatchett, Jr.
Auditor of Public Accounts
144 Capitol Annex
Frankfort, KY 40601
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(Frankfort - October 16, 2003)
In a report released today State Auditor Ed Hatchett said there are few initiatives to curb fraud among Supplemental Security Income (SSI) applicants. In Kentucky, SSI recipients are automatically eligible for Medicaid.
In FY 2002, there were 183,802 SSI recipients in Kentucky who received over $1.4 billion in Medicaid services. "Without proactive fraud detection by DDS, those who are truly disabled and economically disadvantaged may see their benefits go to undeserving recipients," said Hatchett.
Auditors found
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It has been more than six years since Kentucky's DDS referred any cases of suspected fraud or abuse to the federal Social Security Administration (SSA) or state enforcement entities.
- Kentucky has no Cooperative Disability Investigations (CDI) Unit dedicated to countering the high risk of fraud and abuse within the SSI program.
- Eligibility data for 10,494 SSI recipients does not contain address information sufficient to determine whether Kentucky residency requirements are met.
- Kentucky is one of only 13 states that allow non-medical personnel to determine SSI eligibility.
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