The U.S. Department of Health and Human Services Office of Inspector General issued a report today detailing the cumulative efforts of state Medicaid Fraud Control Units in dealing with Medicaid fraud, waste and abuse in 2014.
Pharmaceutical settlements are largest recoveries – $1.26 billion
Cumulatively, $1.961 billion was recovered civilly from 889 providers and $293 million recovered from 1,381 providers who were criminally convicted, for a total amount of $2.2 billion.
The largest piece came from 462 civil settlements with pharmaceutical manufacturers that totaled $1.26 billion. Oddly, there were no criminal convictions associated with the group.
Dentists implicated in fraud, waste and abuse nationally less than 40
Dental Medicaid fraud is a minor segment of the total. HHS-OIG reports that 19 dentists across the country were criminally convicted in 2014 with $4,163,020 recovered from them. Civilly, 18 dentists settled claims for a total of $7,824,268.
This is an extremely low number and is great news for the reputation of dentists in Medicaid!
The report also publishes a number of tables showing the various efforts of the states.
Texas MFCU did a good job in relation to other states
Texas MFCU, by far, had the largest number of investigations for fraud at 1,177. Second place was Indiana at 941.
It also faired well when it came to criminal convictions. Texas placed second with 85, just behind Ohio with 88.
With total recoveries, Texas came third, behind New York and Louisiana, with $106 million recovered.