Report: Banned Medicaid providers still participate in some states

August 04, 2015

Hundreds of medical providers banned from a Medicaid program in one state are able to take part in another state's program despite regulations designed to stop them, according to a report by the HHS' Office of the Inspector General. The continued participation of banned providers leaves state Medicaid programs for the poor and disabled vulnerable to fraud, waste and abuse, according to the study, which says the problem reflects a struggle by states to communicate with one another. The study also found that about half of the states were unable to terminate providers enrolled in privately run Medicaid managed care programs, while some refuse to terminate providers still licensed by a medical board.