Gregory Matthews

Director, Healthcare Division @Massachusetts Office Of The Inspector General

The Health Care Division (HCD or the Division) of the Office of the Inspector General (OIG) is authorized, pursuant to Section 161 of Chapter 126 of the Acts of 2022, to conduct reviews and audits of the Health Safety Net (HSN) program. Pursuant to this authority, HCD “shall continue to oversee and examine the practices in hospitals including, but not limited to, the care provided to the uninsured and the resulting free charges.” Moreover, HCD’s broad mandate also includes authority to “study and review the Medicaid program (MassHealth), but not limited to, a review of [MassHealth’s] program’s eligibility requirements, utilization, claims administration and compliance with federal mandates. HCD will collaborate with HSN and MassHealth to identify programmatic vulnerabilities and provide recommendations to improve internal controls and practices to prevent fraud, waste and abuse of funds in these public health care systems. The IGO shall submit a report to the senate and house committees on ways and means on the results of the completed audits, analyses, reviews and investigations conducted by HCD.In addition to HCD’s program reviews and audits, HCD also reviews and investigates individual instances of allegations of provider fraud waste and abuse, and if necessary, make appropriate criminal referrals to law enforcement partners. HCD is also authorized to comment on, report on and otherwise opine on a variety of health care policy issues including equitable access and delivery of services related to practices in hospitals, free care services, Health Safety net and MassHealth. If appropriate HCD may propose legislative and regulatory changes and make recommendations for systemic improvements in public health care programs.