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Program Integrity
Prevention
Detection
Corrective Actions and Recovery


After fraud, waste or abuse is detected then corrective actions are taken to remedy the situation that results from audits and investigations.

Steps includes:

  • Recovery of overpayments occurs in cases when improper payments are identified through an audit. It enables to program to resolve the issue, as well as learn from the issue to inform future prevention and detection activities.
  • Commitments to improve processes or make corrective actions to prevent future errors.
  • Referrals to law enforcement for further action.
  • Data analysis is used to monitor corrective actions and measure ongoing performance. Design a set of tailored measures that a program will use to monitor performance of providers and contractors.

 

 

 

 

 

 

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