1
00:00:00,182 --> 00:00:04,526
An oversight title does not prove that a record was reviewed.

2
00:00:04,526 --> 00:00:07,290
This Livewire page asks whether Medicaid program-integrity,

3
00:00:07,290 --> 00:00:10,054
MMIS, and state-audit records can trace concerns.

4
00:00:10,054 --> 00:00:11,239
Use four checks.

5
00:00:11,239 --> 00:00:14,398
First, intake: was material received, logged, and routed?

6
00:00:14,398 --> 00:00:16,372
Second, scope: were claims, provider-directory,

7
00:00:16,372 --> 00:00:18,742
referral, access, and system records examined?

8
00:00:18,742 --> 00:00:21,111
Third, custody: who held the data,

9
00:00:21,111 --> 00:00:23,875
and were originals and audit logs preserved?

10
00:00:23,875 --> 00:00:26,639
Fourth, outcome: was there a reasoned closure,

11
00:00:26,639 --> 00:00:27,825
referral, or finding?

12
00:00:27,825 --> 00:00:29,405
Keep the boundaries exact.

13
00:00:29,405 --> 00:00:32,959
A contractor's role does not prove conflict or misconduct.

14
00:00:32,959 --> 00:00:35,723
A missing record is a documentation gap,

15
00:00:35,723 --> 00:00:37,303
not proof of destruction.

16
00:00:37,303 --> 00:00:39,277
HHS OIG's 2022 UPIC evaluation

17
00:00:39,277 --> 00:00:40,462
studied 2019 activity;

18
00:00:40,462 --> 00:00:42,831
all four recommendations are now closed.

19
00:00:42,831 --> 00:00:46,780
A complaint or payment anomaly is not proof of fraud.

20
00:00:46,780 --> 00:00:49,149
Read the source-linked questions at david-medeiros.com.