Inspector General | Internal Audit | Investigations | Medicaid Program Integrity | Complaints | Links

Eric W. Miller, Inspector General
2727 Mahan Drive, MS4
Tallahassee, FL 32308
(850) 412-3990
(850) 921-6009 Fax

The Office of the Inspector General is an integral part of the Agency for Health Care Administration (Agency). The purpose of the Office of the Inspector General is to provide a central point for coordination of and responsibility for activities that promote accountability, integrity, and efficiency in the Agency. Section 20.055, Florida Statutes, mandates the duties and responsibilities of each inspector general, with respect to the state agency/department in which the office is established.

The primary mission of the Office of the Inspector General is:

To assist the Secretary and other Agency management in championing accessible, affordable, quality health care for all Floridians by assessing the efficiency and effectiveness of health care administration resource management.

This is accomplished by providing an independent examination and evaluation of Agency programs, activities, and resources and by conducting internal investigations of alleged violations of Agency policies, procedures, rules or laws. Additionally, the Inspector General's mission is accomplished by investigating Medicaid providers suspected of fraud or abuse in the Medicaid program.

For an itemization of the specific duties and responsibilities of the Inspector General, and a summary of the Inspector General's activities for the latest complete fiscal year, please view the Office of the Inspector General Annual Report. [2MB, PDF]


AHCA Fraud Fighter Achievement Award


Office of the Inspector General Organization and Staff
The Inspector General is appointed by and reports to the Secretary. The Inspector General oversees three sections: Internal Audit, Investigations and Medicaid Program Integrity.

Internal Audit - Performs management consultation, management reviews, special projects, and independent audits. Internal Audit provides Agency management with an independent analysis of operations and controls within the Agency and recommends methods by which these functions may be improved in accordance with Sections 20.055(2)(d) and 20.055(5), Florida Statutes.  

Investigations - Provides for the receiving, processing, investigation, and documentation of complaints of alleged violations of Agency policies, procedures, rules, or laws by the Agency or its employees. Conducts investigations pursuant to the Whistle-blower Act in accordance with Sections 112.3187 through 112.31895, Florida Statutes. Other investigations are conducted in accordance with the procedures and standards adopted by the Governor's Council on Integrity and Efficiency.

Medicaid Program Integrity  - Pursuant to Section 409.913, Florida Statutes, investigates providers suspected of fraud or abuse in the Medicaid program. Medicaid Program Integrity also recovers overpayments, issues administrative sanctions, and refers cases of suspected fraud for criminal investigation to the Office of the Attorney General.

Questions and Answers [21KB, MS Word] for Providers whose Medicaid reimbursements are being withheld.

59G-9.070 Administrative Sanctions on Providers, Entities and Persons

Assisted Living Facilities - Information

Senate Bill 1986
Pursuant to Senate Bill 1986 (passed in 2009), the following links are to lists of terminated, sanctioned and excluded Medicaid providers. The Sanctioned and Terminated Provider link will identify those providers who have had a sanction imposed by the Agency.  A sanction is imposed upon a Final Order being filed with the Agency Clerk. 

Sanction and Terminated Providers

Excluded Providers

Explanation and Disclaimer for Sanctioned, Terminated or Excluded Individuals or Entities

The Sanctioned providers list contains those providers that were sanctioned or terminated while rendering services for the Medicaid program.  The Excluded providers link takes you to the U.S. Department of Health & Human Services Office of Inspector General website where you can search their database of excluded providers. Those excluded providers are individuals and entities who cannot participate in any federal or state funded health care programs.

Report Medicaid Fraud 

Avoiding Medicare and Medicaid Fraud and Abuse

Other Inspector General Reports and Resources

How to File a Complaint

Other Links of Interest

Pursuant to Florida Statutes 409.913:

Pursuant to Florida Statutes 20.055:

The State's Efforts to Control Medicaid Fraud and Abuse FY 2012-13 OIG Annual Report 2012-13
The State's Efforts to Control Medicaid Fraud and Abuse FY 2011-12

OIG Annual Report 2011-12

The State's Efforts to Control Medicaid Fraud and Abuse FY 2010-11 OIG Annual Report 2010-11
The State's Efforts to Control Medicaid Fraud and Abuse FY 2009-10 OIG Annual Report 2009-10
The State's Efforts to Control Medicaid Fraud and Abuse FY 2008-09 OIG Annual Report 2008-09
The State's Efforts to Control Medicaid Fraud and Abuse FY 2007-08 OIG Annual Report 2007-08
The State's Efforts to Control Medicaid Fraud and Abuse FY 2006-07 OIG Annual Report 2006-07

OPPAGA Report 14-05: Medicaid Program Integrity Recovers Overpayments in Fee-for-Service and Monitors Fraud and Abuse in Managed Care, January, 2014.

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Inspector General | Internal Audit | Investigations | Medicaid Program Integrity | Complaints | Links

Reporting Medicaid Fraud