Medicaid Investigations Unit
The Attorney General's Medicaid Investigations Unit works to investigate and prosecute health care fraud committed by Medicaid providers, and the, physical abuse of patients and embezzlement of patient funds in Medicaid funded facilities. The Medicaid Investigations Unit (MIU) is staffed by Department of Justice attorneys, investigators, and auditors who are trained in the complexities of health care fraud litigation. The MIU can handle the following types of cases:
- Fraud committed by Medicaid health care providers;
- Physical abuse of patients in Medicaid funded facilities; and
- Embezzlement, theft, and improper commingling of patients' funds in Medicaid funded facilities.
- Suspected incidents of Medicaid Recipent fraud should be reported to the Department of Social Services in the county where the recipient resides.
The MIU works closely with United States Attorneys, District Attorneys, Federal and State law enforcement agencies, and private insurance company fraud units. Their joint investigations of Medicaid fraud, Medicare fraud, Tricare (a military health insurance program), and private insurance fraud can result in criminal charges against health care providers who break the law as well as civil actions to recover overpayments and penalties.
In fiscal year 2005, the MIU successfully
concluded 35 criminal and civil cases and recovered nearly $30 million in restitution,
fines, penalties, and interest in Medicaid and joint health care fraud cases.
During the past five years, the MIU has recovered more than $235 million in 225 criminal
and civil Medicaid and joint health care fraud cases. On average, the MIU has more than
150 cases under investigation.