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Audits Initiated Based on Referrals from BSI

Collaboration between the OSA's audit data analytics unit and its Bureau of Special Investigations led to four audits that were issued in FY20.

In accordance with the standard operating procedure between the Office of the State Auditor's (OSA's) Audit Operation’s Data Analytics Unit, the Bureau of Special Investigation’s (BSI's) Data Analytics Unit, and OSA’s Medicaid Fraud Unit, BSI’s DAU referred six (6) MassHealth providers to OSA’s Medicaid Audit Unit prior to FY20. This cross-unit collaboration led to the Medicaid Audit Unit featuring BSI DAU’s findings in four (4) audits issued in FY20. These audits examined adult foster care, home health, and physical therapy services.

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Audit of the Office of Medicaid (MassHealth)—Review of Claims Submitted by Dr. Joseph O’Connor 

Audit of the Office of Medicaid (MassHealth) – Review of Claims Paid for Services by Old Colony Elder Services (OCES) 

Audit of the Office of Medicaid (MassHealth)—Review of Claims Paid for Services by Boston Senior Home Care (BSHC) 

Audit of the Office of Medicaid (MassHealth)—Review of Claims Paid for Services by WestMass ElderCare, Inc. 

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