Volkan Mujdat Tiryaki - Virginia Ayres

(Organization Name)Incident of Medicaid Fraud and Inaccurate Billing(DATE)Summary of Incident: (Brief paragraph overview to summarize incident and actions taken to date; include specific dates as much as possible)May refer to other data collection sources, i.e., See Investigation Summary Report for full details by date of the investigation and Client Informationspreadsheet with specific data verified. Document and retain a copy of all communications, letters, E-mails, minutes, training materials,memorandums for the record outlining phone conversations, etc. These may also be referenced in the Output column, below.Areas of Concern Activities/Task Agency Contact Output Timeline NotesInvestigation: 1.2.3.4.Data Collection 1.Notification: 1. Notification letter(s)Copy of letter(s)to DOH2. Email notification to Copies of Email(s)3. Letters written toCopies of letter(s)clients4. Notification toMedicaid FraudInvestigation Unit IFrecoupment expectedto be Greater Than$100,000.005.EmployeeSanctions:1.2.Compliance Issue (i.e., Medicaid Fraud/Inaccurate Billing)Page 1 of 2Documentation Completed By: Name and Position

HONORS &AWARDS• General Directorate for Higher Education, Ministry of National Education of theRepublic of Turkey, 2007, fellowship for PhD studies in the USA.• Turkish Institution of Higher Education, 1999-2003, scholarship for undergraduatestudies, Ankara.• Finans Vakfi, 1999-2003, scholarship for undergraduate studies, Istanbul.