2022 Medicaid Fraud Control Unit Data Shows Continued Focus on Criminal Convictions
Highlights
The number of convictions for fraud and patient abuse and neglect in FY 2022 increased, while civil settlements and judgments dipped slightly
Total recoveries by MFCUs declined in 2022, likely due to the decrease in large federal and multistate investigations, which typically result in larger recoveries
Personal care attendants continued to have highest number of fraud convictions; pharmaceutical manufacturers accounted for more civil settlements and judgments than other provider types
The Department of Health and Human Services’ Office of Inspector General (OIG) reported that in the fiscal year ending Sept. 30, 2022, the 53 Medicaid Fraud Control Units (MFCUs) recovered more than $1.1 billion in criminal and civil recoveries, amounting to $3.08 for every dollar spent. This is the fourth year in a row that recoveries topped $1 billion.
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