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The vast majority of providers are dedicated hard working professionals, who accept minimal reimbursement for their efforts. However, a relatively few have2established operations with2the primary intent of defrauding the Medicaid and Medicare Programs. Fraudulent business2practices serve to undermine fair competition and pose a serious threat to our safe and2efficient service delivery system. IFS’ Medicaid and Medicare Fraud Prevention Division (M2FPD) is a formidable ally of all legitimate service providers whose competitive survival is2threatened by unfair business practices. M2FPD will accomplish its mission in three efficient and effective stages: 2
- Brief preliminary risk assessment visits to each Medicaid and/or Medicare service provider.
- Immediate follow-up audits to confirm or resolve high risk assessments; and
- Prompt recommendations for administrative action and a referral to the appropriate law enforcement agency if there is documented reliable evidence of fraud and/or abuse by the Medicaid or Medicare service provider.
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