KENTUCKY — On this week’s “In Focus Kentucky” program, we’re highlighting efforts and updates to Medicaid in Kentucky and the nation.
During this segment, national reporter Taylor Popielarz shares details about Vice President JD Vance’s efforts aimed at eliminating fraudulent activity in the nation’s Medicare and Medicaid programs.
The Trump administration will launch an audit of all 50 states’ federally funded fraud control units to determine if their Medicaid programs comply. The U.S. Centers for Medicare & Medicaid Services has also imposed a six-month moratorium on new hospice and home health agency enrollments in Medicare nationwide.
You can watch the full segment in the player above.
CLICK HERE to read the FULL Vance talks Medicaid fraud – Spectrum News article.
MANAGEMENT & CULTURE (THE “TONE AT THE TOP”)
Fraud thrives in “sloppy” environments where leadership ignores the rules.
- The Fraud Triangle: For fraud to occur, three elements must be present: Pressure (the need for money), Rationalization (thinking “I deserve this”), and Opportunity (weak controls). You can only control the Opportunity.
- Whistleblower Hotline: Provide an anonymous way for staff to report “odd behavior.” Most internal frauds are caught via tips, not audits.
- Background Checks: Conduct credit and criminal record checks for all employees in financial or data-sensitive roles.
- Annual Ethics Training: Make sure every staff member knows that the company has a Zero Tolerance policy toward “borrowing” from petty cash or fudging overtime.