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Program Integrity

The Health Care Authority maintains a strong commitment to identify improper payments, and potential fraud, waste and abuse to ensure that state and federal tax dollars are spent appropriately. This commitment is driven by a firm intent to assure that the right provider is receiving the right payment for the right service at the right time.

The final program integrity recovery and cost savings numbers for state fiscal year (SFY) 2015:

  • Cost to taxpayers: $6,340,960.00
  • Amount recovered or saved: $39,339,388.00
  • Return on investment: 6.2 -to- 1, up 95 percent over the last 4 years
  • Recoveries increased: Almost $10 million over the previous SFY2014, up 34 percent
  • In the last 6 years: Savings or recovery of more than $150 million
  • Identify improper payments
  • Identify potential waste and abuse
  • Collaboration and partnership with internal and external stakeholders to improve accountability for how health care funds are spent