Idaho Medicaid Program Integrity (MPI) is committed to protecting taxpayer dollars through prevention, detection, and the elimination of fraud, waste, and abuse in the Idaho Medicaid Program. Health care providers are encouraged to help attain these goals through self-reporting of claim errors or overpayments.
Medicaid providers can refund overpayments by:
- adjusting or reversing claims through the Gainwell system
- completing an online Provider Self-Report Form
Examples of when to self-report:
- Incorrectly coded services
- Services were provided by an unlicensed or excluded individual
- Services were not rendered
- Services are outside the two-year period for adjusting claims
Per federal regulations, providers must report over payment and return overpayments within 60 days after identified.
Incentives for self-reporting:
- Extended repayment terms
- Waiver of civil monetary penalties
- Quick resolution of over payments
Self report form