Guidelines For Addressing Fraud & Abuse In Medicaid Managed Care

As health care costs continue to rise to unprecedented heights, States are seeking new approaches in
providing health care services for their citizens. More and more States are moving their Medicaid program
away from the traditional fee-for-service (FFS) environment to a managed care system or a capitated
environment. With this shift in health care comes new challenges in containing costs and new opportunities
for fraud and/or abuse to occur . . .