Which organization establishes written policies for Medicaid payment to prevent fraud, waste, and abuse?

The Office of Inspector General (OIG) plays a pivotal role in establishing written policies and guidelines concerning Medicaid payment to combat fraud, waste, and abuse. The OIG is dedicated to protecting the integrity of the Medicare and Medicaid programs and ensures that federal resources are efficiently utilized. Through its efforts, the OIG develops compliance program guidance, conducts audits and investigations, and issues reports that establish best practices to help providers understand their obligations under the law.

This organization specifically focuses on maintaining program integrity and ensuring accountability, thereby preventing fraud and abuse within Medicaid and other federally funded healthcare programs. The development of these policies is crucial as it aids in creating a structured framework that healthcare providers must follow, ultimately leading to improved compliance and ethical practices within the healthcare system.

While other organizations such as the Centers for Medicare & Medicaid Services (CMS) also have a role in policymaking and oversight regarding Medicaid, it is the OIG that explicitly focuses on fraud, waste, and abuse prevention measures through written policies. The Department of Justice (DOJ) is more involved in the enforcement of laws and prosecution of wrongful acts, and the Occupational Safety and Health Administration (OSHA) is primarily concerned with occupational health and safety, making them less relevant to this specific question.