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Audit criticizes W.Va. Medicaid fraud efforts

Sep. 26, 2013 @ 06:22 AM

CHARLESTON, W.Va. (AP) — A legislative audit says West Virginia's efforts to reduce Medicaid fraud and overpayments are lacking.

According to the audit, the West Virginia Medicaid Fraud unit has a backlog of 171 cases involving suspicious billings from health care providers. The backlog includes 23 complaints that are at least four years old.

The Charleston Gazette reports that the audit was released Wednesday during legislative interim meetings.

State Medicaid commissioner Nancy Adkins told a joint legislative committee that the Medicaid Fraud Control Unit recovered nearly $20 million in overpayments last year. The unit's annual budget is about $1 million.

Adkins says additional staff is being hired. Data-analysis technology to flag unusual billing patterns and claims is expected to be online in early 2014.

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