Office of the Inspector General


Divisions of OIG

Board of Review

Investigations & Fraud Management

Medicaid Fraud Control

Office of Health Facility Licensure and Certification

Olmstead

Quality Control

Related Web Sites

Main Office Contact Information

Building #6
State Capitol Complex
Room 817-B
Charleston, WV 25305
Phone: (304) 558-2278
Fax: (304) 558-1992

REPORT FRAUD
Report WV Healthcare Crimes

Report WV Recipient Welfare Fraud
Common Chapters
Common Chapters Manual

IFM Contact Information

Christopher Nelson
Director

 

David Hill

Assistant Director

 

Carolyn Bills
Administrative Services Manager

 

Carol Abbott
Division Secretary

 

Missie Smith

Secretary

 

Building 6
Capitol Complex
Room 817-B
Charleston, WV 25305
Phone: (304) 558-1970
FAX #: (304) 558-2363

E-Mail to:  DHHROIG@wv.gov

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      Investigations & Fraud Management

Conditioning receipt by state agencies of federal matching funds for both the SNAP (formerly Food Stamp) and Medicaid programs is a requirement to investigate alleged benefit recipient misrepresentation, pursue recovery of overpaid funds, and refer apparent violations for prosecutorial evaluation.  Since 1979, the Investigations and Fraud Management (IFM) unit has served to provide this function within the DHHR.  The current IFM  structure includes three (3) sub-units with differing responsibilities, as detailed below.

To make a complaint please click here or call (304) 558-1970.


A Criminal Investigations sub-unit investigates allegations of suspected welfare fraud or other criminal activity involving recipients of DHHR benefits or services.  Other special investigations may include complaints involving (non-Medicaid) providers, vendors or grantees who receive program-related benefits or financial payments for services from DHHR.    Findings are compiled in detailed, written investigative reports which are delivered to county prosecuting attorneys to evaluate for further action.

ROBERT COOPER, SUPERVISOR

Phone:  (304)  465-9613   FAX#: (304) 465-7288

 

TIMOTHY TOMER, SUPERVISOR
Phone: (304) 746-2360     FAX#:  (304) 558-0851


A specialized Claims and Collections sub-unit is responsible for: determining certain recipient benefit overpayment claims;  negotiating appropriate repayment agreements; imposing any applicable program sanctions for violators;  collecting the overpaid benefit amounts; and, the ongoing monitoring as to the status of DHHR debtor-claims.

LENNY MADIA, SUPERVISOR (NORTHERN WV)

TELEPHONE:  (304) 627-2929    FAX# (304) 627-2171

 

PATRICIA L. KERBAWY  (SOUTHERN WV)

TELEPHONE:  (304) 256-6930     FAX# (304) 256-6932


A Front-End Fraud sub-unit performs a more thorough, pre-certification review of applicant/recipient eligibility on cases meeting a certain criteria.  The sub-unit is currently operative in seven (7) West Virginia counties.  This effort is supported by federal agencies providing related, matching program funds as a highly-effective means of preventing recipient abuse or fraud before it occurs.

BRIAN BALLENGEE, SUPERVISOR

TELEPHONE:  (304) 425-8738   FAX# (304) 487-3589


Upon request and with the approval of the Inspector General, the Investigations and Fraud Management unit conducts intra-agency investigations involving allegations of inappropriate employee activity, which might result in administrative (disciplinary) action or referral for criminal prosecution.  All such investigations are of a highly-sensitive nature.  Every effort is made to maintain confidentiality and to protect the individual privacy rights of all potential investigative witnesses or suspects.


IFM AND LAW ENFORCEMENT

  • In 1994 upon application to the West Virginia Department of Public Safety , IFM was assigned an NCIC ORI ("Originating Agency Report Identifier") Number, which operates as an acknowledgment by the United States Department of Justice, Federal Bureau of Investigation that it met all applicable criteria so as to qualify as a "criminal justice agency" as defined by NCIC policy

  • In 1995 upon invitation by the West Virginia Department of Public Safety, IFM became a member of the West Virginia Intelligence Exchange (WVIX), which is a statewide pointer index system for all West Virginia law enforcement agencies, and operates as a repository for criminal intelligence

LINKS

United Council on Welfare Fraud (UCOWF)

National White Collar Crime Center

Secretary of State - WV Corporation Information

USDA Food and Nutrition Service


This site was last modified on 05/01/2013
Please send any Comments or Suggestions to: Carol Abbott