Government watchdog says fraudsters stole nearly $2 billion from Medicaid in 2016

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Nearly 1,600 fraudsters were caught stealing $1.9 billion from Medicaid in 2016, a government watchdog reported Monday.

State-run Medicaid Fraud Control Units (MFCU) investigated and prosecuted the criminals defrauding Medicaid. The Department of Health and Human Development’s Inspector General (IG) – who reported the findings and often assists on cases – awards grants to each unit and provides 75 percent of their funding.

“MFCU’s play a critical role in protecting the taxpayers and the residents of health care institutions,” IG Special Agent Shimon Richmond said in a podcast.

The IG director of the units, Richard Stern, added: “MFCUs investigate, and prosecute, patient abuse or neglect in nursing homes, and hospitals, as well as in assisted living facilities” in addition to fighting fraud.

California had the most convictions at 173, followed by Ohio with 126. Investigators in New York recovered more funds than any other state at nearly $229 million. Florida was second with nearly $166 million recovered.

AXIR Consulting

New York’s Medicaid Fraud Control Unit is also the largest staffed by far with 298 on board. California, the second largest unit, has 185 staff.

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