According to a recent report from the U.S. Department of Health and Human Services’ Office of Inspector General (OIG), recent enforcement activity for Medicaid fraud and/or patient abuse cases still hasn’t reached pre-pandemic levels, but has risen from previous declines.
However, the report, which covers Medicaid Fraud Control Unit (MFCU) enforcement activity in fiscal year (FY) 2021, shows that while the number of cases is down, the penalties for those committing patient abuse and/or Medicaid fraud are much stiffer, as recoveries are up over previous years. The report also shows that labs are still a key target for Medicaid civil actions. Here’s a summary of some of the key numbers in the report:
- 1,105: Total convictions, including;
- 780: Convictions due to fraud; and
- 325: Convictions due to patient abuse or neglect;
- 540: Individuals or entities excluded from federally funded health programs;
- 716: Civil settlements and judgments;
- $1.7 billion: Total amount recovered by MFCUs, including;
- $856.6 million: Criminal recoveries; and
- $826.2 million: Civil recoveries
- $5.36: How much MFCUs recovered for every $1.00 spent.
For a more in-depth analysis of the report, stay tuned for our May 2022 issue of National Lab Reporter.