Medicaid Fraud Control Units Yielding Results

While the Medicaid Recovery Auditor (RAC) program has continued to struggle to return funds to the Medicare program, state Medicaid Fraud Control Units (MFCUs) continue to see significant financial returns.

Released at the end of April, the U.S. Department of Health and Human Services (HHS) Office of Inspector General’s (OIG’s) 2014 fiscal year report on MFCUs shows total recoveries of just over $2 billion. While this total is down from the $2.5 billion collected in 2013, the total amount collected represents a return rate of $8.53 for every dollar invested in MFCUs via grant dollars.

A majority of the difference in dollars between the last two fiscal years can be accounted for by the drop in recoveries from the state of Virginia. In 2013, Virginia managed to collect over $1 billion, with over $700 million of that total coming from criminal convictions. This figure dropped to a mere $64.7 million for 2014.Other state MFCUs that have had solid collection records in the past continued the pattern. The state of New York led all states with collections totaling over $378 million. The surprising second-place finisher was Louisiana, with collections totaling over $245 million.

Source: Medicaid Fraud Control Units Yielding Results

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