The Agency for Health Care Administration continues to coordinate efforts to prevent and detect fraud and abuse in its Medicaid fee-for-service and managed care programs. It oversees fraud and abuse prevention and detection in Medicaid managed care by requiring plans to perform specific fraud and abuse activities and by monitoring to ensure that plans comply with these requirements. For fee-for-service, the agency follows a systematic process to identify and investigate providers who are suspected of overbilling.
The agency has reduced the time it takes to recover overpayments from providers and has increased the fines and penalties imposed for provider overbilling.

Biennial Review of AHCAs Oversight of Fraud, Waste, and Abuse in Florida's Medicaid Program
Report 22-03 January 2022
Biennial Review of AHCAs Oversight of Fraud, Waste, and Abuse in Florida's Medicaid Program
Report 22-03 January 2022
AHCA Continues to Improve Medicaid Program Data Quality and Oversight; Additional Improvements Needed in Use of Data
Report 20-04 January 2020
AHCA Continues to Expand Medicaid Program Integrity Efforts; Establishing Performance Criteria Would Be Beneficial
Report 18-03 January 2018

Copies of this report in print or alternate accessible format may be obtained by email OPPAGA@oppaga.fl.gov, telephone (850) 488-0021, or mail 111 W. Madison St., Room 312 Tallahassee, FL 32399-1475.