According to a statement by Governor Steve Beshear, Kentucky has hired Ingenix to detect fraud, waste and abuse in the state’s Medicaid program. The state estimates that $27 million in overpayments, alone, will be identified with the new system.
Gov. Beshear says Ingenix will have a three-year contract, contingent on the amount of Medicaid overpayments recovered. “In a program the size of Kentucky’s Medicaid program, which continues to grow both in costs and people served, having the most vigilant waste, fraud and abuse detection system in place is critical,” Gov. Beshear, said in a statement.
“This contract represents a multi-faceted and technologically sophisticated approach to detecting and remedying any unnecessary expenditures, and that is good news for Kentucky taxpayers,” he said.
The contract seeks to root out waste and fraud by both providers and recipients by running analytics to predict and detect abusive practices. The company will also conduct onsite audits, desk audits and pre-payment reviews. Ingenix will also consult the Kentucky Department for Medicaid Services on policy and system issues vis-à-vis any changes in federal regulations.
The Minnesota-based Ingenix has Medicaid program integrity contracts with several states, including Washington, Alabama and Iowa.
According to contract terms, the contract could be worth over $3.3 million per year.