5 states top Medicaid fraud list, States recover $1.7B

States recovered $1.7 billion through Medicaid fraud and patient abuse investigations and enforcements of civil and criminal cases, the Office of Inspector General reported last week.

The Medicaid Fraud Control Units (MFCUs) investigate and prosecute fraud, as well as patient abuse and neglect at healthcare facilities. In fiscal year 2011, MFCUs conducted 10,685 Medicaid fraud investigations and saw 824 convictions. MFCUs conducted 4,134 investigations into patient abuse and neglect, including patient funds cases, and saw 406 convictions.

The federal and state government spent a combined $208.6 million on MFCUs. The OIG reported that return on investments translated to $8.39 for every $1 that the federal and state governments spent to operate the MFCUs.

MFCUs recovered the highest amounts from California, Texas, New York, Ohio and Kentucky in 2011, according to OIG data.

State

Indicted/ charged

Convictions

Civil settlements / judgments

Total recovery

California

151

123

21

$388.26M

Texas

170

118

15

$190.87M

New York

80

89

108

$136.44M

Ohio

144

116

27

$82.48M

Kentucky

6

18

28

$81.44M


For more information:
- read the OIG summary
- check out the Medicaid fraud map
- see the Medicaid chart (.xls)

Related Articles:
State regulators pull back on Medicaid audits
State to start anti-Medicaid fraud verification without fed approval
OIG critiques deployment of Medicaid integrity contractors
Feds' $5.6B fraud collection hits record high
Feds recover $1.84B from Medicaid fraud: 5 states top the list

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