20-77-2509. Reports required of Medicaid Inspector General — Definition.

20-77-2509. Reports required of Medicaid Inspector General — Definition. (a) The Medicaid Inspector General shall, no later than October 1 of each year, submit to the Secretary of the Department of Inspector General, the President Pro Tempore of the Senate, the Speaker of the House of Representatives, Arkansas Legislative Audit, the Legislative Council, and the Attorney General a report summarizing the activities of the Office of Medicaid Inspector General during the preceding calendar year. (b) The report required under subsection (a) of this section shall include without limitation: (1) The number, subject, and other relevant characteristics of: (A) Investigations initiated and completed, including without limitation outcome, region, source of complaint, and whether or not the investigation was conducted jointly with the Attorney General; (B) Audits initiated and completed, including without limitation outcome, region, the reason for the audit, the total state and federal dollar value identified for recovery, the actual state and federal recovery from the audits, and the amount repaid to the Centers for Medicare & Medicaid Services; (C) Administrative actions initiated and completed, including without limitation outcome, region, and type; (D)(i) Referrals for prosecution to the Attorney General and to federal or state law enforcement agencies and referrals to licensing authorities. (ii) Information reported under subdivision (b)(1)(D)(i) of this section shall include without limitation the status and region of an administrative action; (E) Civil actions initiated by the office related to improper payments, the resulting civil settlements entered, overpayments identified, and the total dollar value identified and collected; and (F) Administrative and education activities conducted to improve compliance with Medicaid program policies and requirements; and (2)(A) A narrative that evaluates the office's performance, describes specific problems with the procedures and agreements required under this section, discusses other matters that may have impaired the office's effectiveness, and summarizes the total savings to the state medical assistance program. (B)(i) In addition to total savings, the narrative shall detail net savings in state funds. (ii) As used in subdivision (b)(2)(B)(i) of this section, “net savings” means amounts recovered by the office less payments made to the Centers for Medicare & Medicaid Services and the costs of state administrative procedures. (c) The office may subpoena individuals, books, electronic and other records, and documents that are necessary for the completion of reports under this section. (d)(1) In making the report required under subsection (a) of this section, the Medicaid Inspector General shall not disclose information that jeopardizes an ongoing investigation or proceeding. (2) The Medicaid Inspector General may disclose information in the report required under subsection (a) of this section if the information does not jeopardize an ongoing investigation or proceeding and the Medicaid Inspector General fully apprises the designated recipients of the scope and quality of the office's activities. (e) Quarterly by April 1, July 1, October 1, and January 1 of each year, the Medicaid Inspector General shall submit to the Secretary of the Department of the Inspector General, the President Pro Tempore of the Senate, the Speaker of the House of Representatives, Arkansas Legislative Audit, the Legislative Council, and the Attorney General an accountability statement providing a statistical profile of the referrals made to the Medicaid Fraud Control Unit of the Office of the Attorney General, audits, investigations, and recoveries.