3-30-2018 | Report (OEI-09-18-00180) | Complete Report

OIG Medicaid Fraud

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Medicaid Fraud Control Units (MFCUs or Units) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. They operate in 49 States and the District of Columbia. The Department of Health and Human Services Office of Inspector General is the designated Federal agency that oversees and annually approves Federal funding for MFCUs through a recertification process. For this report we analyzed the annual statistical data on case outcomes—such as convictions; civil settlements and judgments; and recoveries—that the 50 MFCUs submitted for fiscal year 2017.

A graphic showing key statistics from the report. View a text-based version of this graphic using the link below.

  • 1,528 Convictions
    • 1,157 Fraud
    • 371 Patient Abuse or Neglect
  • 961 Civil Settlements and Judgments
  • 1,181 Individuals or Entities Excluded from federally funded health programs
  • Civil Recoveries
    • 69% Nonglobal Cases
    • 31% Global Cases
  • $693 Million Criminal Recoveries
  • $1.1 Billion Civil Recoveries
  • $1.8 Billion Recovered
    • MFCUs recovered $6.52 for every $1 spent