191.909. Reports required, contents.
Reports required, contents.
191.909. 1. By January 1, 2008, and annually thereafter, theattorney general's office shall report to the general assembly and thegovernor the following:
(1) The number of provider investigations due to allegations ofviolations under sections 191.900 to 191.910 conducted by the attorneygeneral's office and completed within the reporting year, including the ageand type of cases;
(2) The number of referrals due to allegations of violations undersections 191.900 to 191.910 received by the attorney general's office;
(3) The total amount of overpayments identified as the result ofcompleted investigations;
(4) The amount of fines and restitutions ordered to be reimbursed,with a delineation between amounts the provider has been ordered to repay,including whether or not such repayment will be completed in a lump sumpayment or installment payments, and any adjustments or deductions orderedto future provider payments;
(5) The total amount of monetary recovery as the result of completedinvestigations;
(6) The total number of arrests, indictments, and convictions as theresult of completed investigations.
An annual financial audit of the MO HealthNet fraud unit within theattorney general's office shall be conducted and completed by the stateauditor in order to quantitatively determine the amount of money investedin the unit and the amount of money actually recovered by such office.
2. By January 1, 2008, and annually thereafter, the department ofsocial services shall report to the general assembly and the governor thefollowing:
(1) The number of MO HealthNet provider and participantinvestigations and audits relating to allegations of violations undersections 191.900 to 191.910 completed within the reporting year, includingthe age and type of cases;
(2) The number of MO HealthNet long-term care facility reviews;
(3) The number of MO HealthNet provider and participant utilizationreviews;
(4) The number of referrals sent by the department to the attorneygeneral's office;
(5) The total amount of overpayments identified as the result ofcompleted investigations, reviews, or audits;
(6) The amount of fines and restitutions ordered to be reimbursed,with a delineation between amounts the provider has been ordered to repay,including whether or not such repayment will be completed in a lump sumpayment or installment payments, and any adjustments or deductions orderedto future provider payments;
(7) The total amount of monetary recovery as the result of completedinvestigation, reviews, or audits;
(8) The number of administrative sanctions against MO HealthNetproviders, including the number of providers excluded from the program.
An annual financial audit of the program integrity unit within thedepartment of social services shall be conducted and completed by the stateauditor in order to quantitatively determine the amount of money investedin the unit and the amount of money actually recovered by such office.
(L. 2007 S.B. 577)