MO SB1042

Establishes the Office of the MO HealthNet Inspector General as a type III agency within the Department of Social Services, transferring the MO HealthNet participant fraud unit from the legal services division to the new office

The MO HealthNet Inspector General must be an attorney licensed in the United States, appointed by the governor with Senate consent for a five-year term, and cannot have served as an executive or manager of any MO HealthNet program within the preceding two years

Office responsibilities include detecting, preventing, and investigating fraud and abuse; recovering improperly expended funds; enforcement; audit; quality review; compliance; referral of criminal prosecutions; and oversight of fraud and abuse information technology

Inspector General has authority to coordinate with the Department of Health and Senior Services, Department of Mental Health, Attorney General's office, and health insurers; establish payment withholding and exclusion guidelines; review service utilization and expenditures; and conduct investigations and criminal referrals

Inspector General may only be removed by the governor for cause upon notice and opportunity to be heard, and shall function independently with respect to office operations, investigations, and findings