Wisconsin In-Network Transportation Provider Checklist

Several states have enacted False Claims Acts that are similar in substance and procedure to theFederal laws described, above. At present, these States include AR, CA, DE, DC, FL, GA, HI,IN, IL, LA, MA, MI, MN, MO, MT, NH, NJ, NM, NY, NV, OK, RI, TN, TX, VA, and WI. Inaddition, the municipalities of Chicago and New York City have enacted False Claims Acts thatare similar in substance and procedure to the Federal laws described above.Fraud, Waste And Abuse / Company DetectionLogistiCare has numerous policies and procedures for detecting fraud, waste and abuse. Some ofour more important procedures are (1) the gate keeping protocol performed during thereservation process; (2) the detailed verification process for each invoice submitted bytransportation providers; (3) recertification of standing orders, (4) sampling patient attendancerecords with health care facilities; (5) background check requirement for transportationproviders; (6) field monitor activities; and (7) requirement of preauthorization and job number.LogistiCare takes seriously any allegation of fraud, waste or abuse, and appropriatelyinvestigates any such allegation. Providers are required to report suspected cases of fraud, waste,abuse or other impropriety. Providers must cooperate in any investigations initiated byLogistiCare or any government agency, as required by law.Wisconsin NET ProgramVersion: March 25 2011Page 39