Medicaid Preliminary Investigations
The Medicaid Preliminary Investigations Branch staff conducts Medicaid preliminary investigations of Medicaid providers alleged to have questionable or inappropriate billing practices. Branch staff coordinates with and refers cases to law enforcement and the OAG Medicaid Fraud Control Unit as appropriate. Staff also works with the Medicaid Department for Program Integrity on non-criminal cases that require administrative action.
Another type of investigation conducted by branch staff includes the improper use of Medicaid cards by Medicaid members. Staff coordinates the necessary prosecution or administrative action for these types of cases as well.
Authority for this branch is found in KRS 194A.030 and KRS 205.8453.
Derek Gould, Branch Manager