News, Payment/economy, Skilled Nursing Facility

Medicaid Fraud Control Units recover over $10 million in 2013

Medicaid Fraud Control Units recovered about $10.3 million from nursing facilities in FY 2013, according to an annual report issued Friday. Practically every state operates a fraud control unit, and the report from the Department of Health and Human Services Office of the Inspector General compiled results from all of these units.

The investigations included:

  • Allegations of criminal and civil fraud
  • False claims
  • Allegations of abuse and neglect

Civil fraud settlements and judgments accounted for the majority of nursing home recoveries last fiscal year, according to the report. These cases led to $8.3 million in recoveries. Criminal fraud investigations led to about $1.1 million being recovered. Civil abuse and neglect cases represented about $771,000 in recoveries, and criminal abuse and neglect convictions resulted in almost $155,000 being recovered, the report stated.

To read the full report, click here.