The OIG has released its Medicaid Fraud Control Units (MFCU) Fiscal Year 2014 Annual Report, which highlights statistical achievements of the 50 MFCUs nationwide, along with related OIG oversight activities. With regard to criminal cases, the report notes:
- MFCUs reported 1,318 criminal convictions, most frequently involving home health care aides, certified nursing aides, and other medical support;
- Three-quarters of MFCU criminal convictions were for fraud; and
- MFCU recoveries from criminal cases in FY 2014 reached nearly $300 million.
With regard to civil cases, the report explains:
- MFCUs reported 874 civil settlements and judgments, with 52 percent of cases involving pharmaceutical companies;
- Two-thirds of MFCU civil settlements and judgments were global settlements (civil false claims cases brought by the U.S. Department of Justice involving a group of State MFCUs); and
- FY 2014 recoveries from civil cases totaled $1.7 billion; recoveries from global cases accounted for 69 percent of these recoveries.
In addition, the OIG excluded 1,337 providers from federal health programs in FY 2014 as a result of MFCU investigations, prosecutions, and convictions.