TMPPM 2008 > Provider Information > Provider Enrollment and Responsibilities > Medicare/Medicaid Waste, Abuse, and Fraud Policy

1.3.2 Suspected Cases of Provider Waste, Abuse, and Fraud

The HHSC OIG is responsible for minimizing the opportunity for provider waste, abuse, and fraud. HHSC takes appropriate action to protect clients and the Texas Medicaid Program when providers of services are suspected of committing waste, abuse, or fraud. HHSC OIG is responsible for establishing criteria for identifying cases of possible waste, abuse, or fraud and recouping all overpayments from a provider. Some circumstances may result in referral of a provider to the Texas Attorney General's MFCU or Antitrust and Civil Medicaid Fraud Section for further investigation, whereas other circumstances might result in administrative sanctions or actions deemed appropriate by the HHSC OIG.