Gov. Asa Hutchinson and the Arkansas Department of Human Services Division of Medical Services and Office of Medicaid Inspector General have proposed establishing a new Payment Integrity Unit.
The unit would be within DHS and a corresponding division within OMIG.
“Among the seven elements of health care reform that I outlined to the legislative task force was improving the integrity of the Medicaid program,” Hutchinson said in a statement. “This is an important step in that direction. We have an obligation to the taxpayers of Arkansas to make certain public programs like Medicaid are run efficiently and with integrity.”
According to a news release, Arkansas has annual Medicaid recoveries of only 4 basis points per year (0.04 percent, or $2.1 million) — compared to Florida (0.17 percent), Georgia (0.35 percent) and Arizona (0.44 percent), Arkansas has significant room for growth and increased savings.
The new unit will focus on prevention and recovery by utilizing data analytics and industry best practices to identify systemic sources of waste. DHS and OMIG will collaborate on correcting the existing policies, new training for DHS and provider staff, and addressing shortcomings in the current claim processing procedures.
DHS will gain five new positions and OMIG will gain two positions — all funded by DHS through savings expected as a result of enhanced payment integrity functions.
The new DHS staff will report directly to the DHS deputy director and will include a unit lead, a vendor manager, a clinical expert and two new analysts. OMIG staff will include a division manager to highlight the necessary changes in policy and coordinate those efforts with DHS and the support specialist will handle the analysis of issues raised by vendors and conduct research in support of the initiative.
