Finding 370427 (2023-001)

The District discovered fraud during the fiscal year shortly after the incidents had occurred. An individual working for the District recorded making home visits to patients in the Nurse Family Partnership (NFP) program when in fact, the visits were not made nor hade the employee tried to cancel or reschedule the visits with the patients. The incidents of fraud were discovered by the employee's supervisor during a review and follow up with patients assigned to the employee. The issue was immediately reported to the State and billing to the program ceased while an investigation was completed. The State reported the incident to their federal partners and the District has complied in a quick and timely manner with all requests from the State and federal partner. The incidents were also reported to Medicaid because some unverified visits had been billed to Medicaid, and Medicaid was fully reimbursed for all unverified visits. Additionally, the District has put in place additional layers of controls which are above normal industry standards to prevent this type of activity from occurring in the future.