Program Compliance Bureau
The Program Compliance Bureau is part of the Quality Assurance Division of the Montana Department of Public Health and Human Services. It encompasses three programs:
- Surveillance and Utilization Review . This unit is responsible for protecting the integrity of the Montana Medicaid Program from fraud and abuse.
- Third Party Liability. This unit identifies Medicaid recipients who have other medical insurance or payment sources with which to pay their health-care costs before they rely on Medicaid.
- Program Integrity. This unit 1) investigates intentional fraud of recipient eligibility in the Food Stamp, Temporary Assistance for Needy Families (TANF), and Medicaid programs; 2) helps establish, monitor, reconcile and negotiate repayments of recipient claims for Food Stamps, TANF, and Medicaid; and 3) performs federally mandated quality-control reviews for the Food Stamp and Medicaid programs.
To contact the Program Compliance Bureau
Recipient Eligibility Fraud Hotline: 800-201-6308
Recipient Abuse (Team Care) Fraud Hotline: 800-362-8312
Provider Fraud Hotline: 800-376-1115
Program Compliance Bureau Chief
Surveillance and Utilization Review Supervisor
Program Integrity Supervisor
Third Party Liability Supervisor
HIPAA Program Officer