Program Compliance

The Program Compliance Bureau is part of the Office of Inspector General of the Montana Department of Public Health and Human Services. It encompasses three units:

  • Program Integrity  unit investigates allegations of intentional fraud of recipient eligibility in the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Medicaid and Low Income Energy Assistance Program (LIEAP).
  • Quality Control  unit conducts federally mandated random reviews of recipient eligibility in the SNAP and Medicaid programs. These reviews are conducted to provide information on the accuracy of eligibility determinations. The results of these reviews are used as a basis to reduce or eliminate the causes of incorrect payments made to recipients.
  • Surveillance Utilization Review Section   unit is responsible for protecting the integrity of the Montana Medicaid Program from Provider fraud, waste and abuse.
  • Third Party Liability   unit manages estate recovery, Medicare buy-in, casualty recovery, Health Insurance Premium Payments (HIPP) and the collection of benefit over-issuance.

The Program Compliance Bureau also monitors Payment Error Rate Measurement (PERM), Medicaid Eligibility Quality Control (MEQC), and Recovery Audit Contract (RAC).

  • The   Payment Error Rate Measurement (PERM)  was developed by CMS to comply with rules and guidance issued by the Federal Office of Management and Budget. PERM reviews payments for fee-for-service, managed care and eligibility for Medicaid and CHIP. PERM is administered by CMS.
  • Medicaid Eligibility Quality Control (MEQC) conducts federally mandated random reviews of recipient eligibility in the Child Health Insurance Program (CHIP) and Medicaid.  MEQC complements PERM and is intended to prompt states to take action in mitigating risks for improper payments and to improve the accuracy of their eligibility determinations in-between PERM review years.  MEQC ensures that CHIP and Medicaid eligibility is determined correctly, recipients are placed in the correct eligibility category, and the related expenses are paid at the correct Federal Medical Assistance Percentages (FMAPs).  
  • The   Recovery Audit  identifies and recovers improper Medicaid Provider payments.

To contact the Program Compliance Bureau

Recipient Eligibility Fraud Hotline: 800-201-6308
or email Recipient Eligibility Fraud to:

Recipient Abuse (Team Care) Fraud Hotline: 800-362-8312
Provider Fraud Hotline: 800-376-1115

Program Compliance Bureau Chief
Heather Smith
(406) 444-4171

IPV / MEQC / PERM Supervisor
 Amy Kohl
(406) 444-9356

 SNAP Quality Control Supervisor 
Jenna Wright
(406) 791-6222

Surveillance Utilization Review Section Supervisor
Jennifer Tucker
(406) 444-4586

Third Party Liability Supervisor
Olivia Roussan
(406) 444-6004

Primary PERM Contact
Valerio Varani
(406) 444-9365

Recovery Audit Coordinator
Heather Smith
(406) 444-4171