Corporate Compliance

State Medicaid Fraud Control Units recovered $1.3 billion in 2008

Compliance Monitor, August 12, 2009

State Medicaid Fraud Control Units (MFCU) recovered $1.3 billion in court-ordered restitution, fines, civil settlements, and penalties for fiscal year 2008, according to an August 7 Office of Inspector General (OIG) report.
MCFUs also obtained 1,314 convictions; achieved 971 civil settlements and/or judgments; and excluded 755 providers from participation in the Medicare, Medicaid, and other Federal health care programs in FY 2008, the report stated.
The mission of the MFCUs is to investigate and prosecute Medicaid provider fraud and patient abuse and neglect. Forty-nine states and the District of Columbia have MFCUs—North Dakota does not have an MFCU.
The report highlights a settlement between the New York MFCU and Staten Island University Hospital (SIUH) and SIUH Systems, Inc., in which SIUH agreed to pay the Medicaid program $24.8 million. The settlement resolved allegations that SIUH Systems billed Medicaid for detoxification treatment provided in a special unit of the hospital without a state-issued certificate of operation.

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