Sarbanes Oxley Act of 2002 Paper
Sarbanes-Oxley Act of 2002 Paper
Stephanie R Spaulding
ACC/561
September 1, 2014
James Sullivan
Sarbanes-Oxley Act of 2002 Paper
The Department of Social Services in the State of Missouri does not have much success even with the Sarbanes-Oxley Act of 2002 implemented. This act was put in place to reduce public fraud and in this organization; the fraud still seems to be increased. Although Medicaid Fraud and Compliance has been overwhelming even with preventative measures in place, an area that hits close to home for me is the amount of child care reimbursement fraud that exists within the state. In comparison, these two types of fraud are extensive and continue to occur at rapid pace within the State of Missouri.
Medicaid Fraud and Compliance
For the purpose of preventing Medicaid fraud, the Department of Social Services has established a hotline that can be utilized for reporting fraud. In addition to the Sarbanes-Oxley Act of 2002, (Missouri Department of Social Services, 2014) the Social Security Act in accordance with the Affordable Care Act requires states to contract with a Recovery Audit Contract vendor and allows states to reimburse contractors who assist in the identification and recovery of improper payments. Furthermore, the Deficit Reduction Act of 2006, the Medicaid Integrity Program utilizes Medicaid Integrity Contractors (MICs) to analyze Medicaid claims data and to identify high-risk areas and potential vulnerabilities, as well as conduct post-payment audits. Missouri’s MICs conduct audits of Missouri hospice providers. The MICs may request documentation that supports Medicaid-enrolled participants’ eligibility for hospice, and other documents to ensure proper billing. The Recovery Audit Contract vendor will be reviewing paid claims for proper billing, and to ensure the claims were not paid twice (duplicate billing) and that proper quantities were billed. Finally, they may request documentation to include items such as a
Stephanie R Spaulding
ACC/561
September 1, 2014
James Sullivan
Sarbanes-Oxley Act of 2002 Paper
The Department of Social Services in the State of Missouri does not have much success even with the Sarbanes-Oxley Act of 2002 implemented. This act was put in place to reduce public fraud and in this organization; the fraud still seems to be increased. Although Medicaid Fraud and Compliance has been overwhelming even with preventative measures in place, an area that hits close to home for me is the amount of child care reimbursement fraud that exists within the state. In comparison, these two types of fraud are extensive and continue to occur at rapid pace within the State of Missouri.
Medicaid Fraud and Compliance
For the purpose of preventing Medicaid fraud, the Department of Social Services has established a hotline that can be utilized for reporting fraud. In addition to the Sarbanes-Oxley Act of 2002, (Missouri Department of Social Services, 2014) the Social Security Act in accordance with the Affordable Care Act requires states to contract with a Recovery Audit Contract vendor and allows states to reimburse contractors who assist in the identification and recovery of improper payments. Furthermore, the Deficit Reduction Act of 2006, the Medicaid Integrity Program utilizes Medicaid Integrity Contractors (MICs) to analyze Medicaid claims data and to identify high-risk areas and potential vulnerabilities, as well as conduct post-payment audits. Missouri’s MICs conduct audits of Missouri hospice providers. The MICs may request documentation that supports Medicaid-enrolled participants’ eligibility for hospice, and other documents to ensure proper billing. The Recovery Audit Contract vendor will be reviewing paid claims for proper billing, and to ensure the claims were not paid twice (duplicate billing) and that proper quantities were billed. Finally, they may request documentation to include items such as a
References: Coenen, Tracy. 2010. Fraud Files: How Well Does Sarbanes-Oxley Reduce Fraud Risk? Retrieved from website: http://www.dailyfinance.com/2010/07/16/fraud-files-how-well- does-sarbanes-oxley-reduce-fraud-risk/ Hayes, Chris. 2013. Fox 2 News Article: St. Louis City daycare shut down. Retrieved from website: http://fox2now.com/2013/07/15/st-louis-city-daycare-shut-downed/ Missouri Department of Social Services. 2014. Update on Recovery Audit Contractor (RAC) and Medicaid Integrity Contractor (MIC) Activities. Retrieved from website: http://mmac.mo.gov/update-on-recovery-audit-contractor-rac-and-medicaid-integrity- contractor-mic-activities/