艾奥瓦州发布医疗补助反欺诈工作组最终报告：五项建议强化监管、数据分析与公众举报
艾奥瓦州州长金·雷诺兹（Kim Reynolds）10月29日在州府得梅因发布了医疗补助欺诈消除工作组（Medicaid Fraud Elimination Task Force）的最终报告。该工作组由州长2026年7月1日的行政令设立，州长任命州总检察长 Brenna Bird 担任主席，并责成成员提出在艾奥瓦州医疗补助（Medicaid）体系内预防和消除欺诈、浪费与滥用的策略建议。
最终报告提出五项主要建议：优化艾奥瓦州医疗补助欺诈控制单位（Medicaid Fraud Control Unit）；改善医疗补助欺诈的公众认知与举报渠道；强化高风险医疗补助服务的质量与项目完整性；最大限度运用技术与数据分析；以及加强对管理式医疗组织（MCO）网络的管理。州长办公室表示，许多建议可在现有授权下实施，部分则需要拨款或立法。
工作组成员还包括州卫生与公共服务厅首席副厅长 Larry Johnson、艾奥瓦州医疗补助局局长 Lee Grossman、检查申诉与许可厅代理厅长 Aaron Baack、医疗补助欺诈控制单位主任 Jeremy Ingrim、公共安全厅厅长 Steve Bayens、管理厅厅长 Kraig Paulsen、州长办公室的 Dax Oberreuter，以及 Wellpoint Iowa、Iowa Total Care 与 Molina Healthcare of Iowa 三家管理式医疗组织各一名成员。
雷诺兹表示，她感谢总检察长 Bird 与工作组全体成员的投入，他们的努力将帮助艾奥瓦州的医疗补助体系成为全国最具问责性与安全性的体系之一；在保护纳税人对这些项目投资的同时，州政府同样专注于确保每位依赖该体系的合格艾奥瓦州居民都能获得优质的护理与服务。Bird 表示，每一美元被医疗补助欺诈夺走的钱，都是从需要该项目的弱势居民与以税收供养它的勤劳居民手中偷走的，工作组的建议为积极根除欺诈、浪费与滥用提供了关键工具，她期待与州长及州议会共同推进这些建议。
Iowa Releases Medicaid Fraud Task Force Final Report: Five Recommendations on Oversight, Data Analytics and Public Reporting
Iowa Governor Kim Reynolds issued on October 29 in Des Moines, Polk County, Iowa, the final report from the Medicaid Fraud Elimination Task Force, which was established by executive order on July 1, 2026. The governor appointed Attorney General Brenna Bird to chair the task force and directed its members to recommend strategies to prevent and eliminate fraud, waste and abuse within Iowa's Medicaid system.
The final report includes five principal recommendations: optimizing Iowa's Medicaid Fraud Control Unit; improving Medicaid fraud public awareness and reporting channels; strengthening quality and program integrity in high-risk Medicaid services; maximizing technology and data analytics; and strengthening managed care organization (MCO) network management. The governor's office said many of the recommendations can be implemented under existing authority, while some require appropriations or legislation.
Other members of the task force included Larry Johnson, Principal Deputy Director of the Department of Health and Human Services; Lee Grossman, Director of Iowa Medicaid; Aaron Baack, Interim Director of the Department of Inspections, Appeals, and Licensing; Jeremy Ingrim, Director of Iowa's Medicaid Fraud Control Unit; Steve Bayens, Commissioner of the Department of Public Safety; Kraig Paulsen, Director of the Department of Management; Dax Oberreuter of the Office of the Governor; and one member from each of Iowa's managed care organizations: Wellpoint Iowa, Iowa Total Care, and Molina Healthcare of Iowa.
"I want to thank Attorney General Bird and all the members of the Medicaid Fraud Elimination Task Force for their dedication to further strengthening Iowa's Medicaid system," Governor Reynolds said. "Their efforts will help make it one of the most accountable and secure in the nation." Attorney General Bird said every dollar lost to Medicaid fraud is a dollar stolen from vulnerable Iowans who need the program and the hardworking Iowans who fund it, and that the task force's recommendations provide critical tools to proactively root out fraud, waste and abuse.
来源：GSM·美国（原文链接）
图片来源：艾奥瓦州法律图书馆（资料图）。CC BY，Thesavagenorwegian摄，经 Wikimedia Commons。 / Iowa State Law Library (file photo). CC BY, by Thesavagenorwegian, via Wikimedia Commons.
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