A service of the California Health Care Foundation

California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

Calif. Top State in Recouping Funds From Medicaid Fraud

In fiscal year 2011, California recovered $388.26 million through Medicaid fraud and patient abuse investigations, as well as civil and criminal cases, according to a report from HHS Office of the Inspector General, FierceHealthcare reports.

The amount is the most recovered by any state that year.

National Findings

In total, states recovered $1.7 billion through Medicaid fraud and patient abuse cases in FY 2011.

Federal and state governments in FY 2011 spent $208.6 million on Medicaid Fraud Control Units, which investigate and prosecute fraud, patient abuse and neglect at health care organizations.

MFCUs in FY 2011 conducted 10,685 Medicaid fraud investigations -- which yielded 824 convictions -- and 4,134 investigations into suspected patient abuse and neglect, which yielded 406 convictions (Cheung, FierceHealthcare, 4/3).

Overall, federal and state governments recouped $8.39 for every dollar spent on the MFCUs, the report found (HHS OIG report summary, 4/3).

Top States for Recovering Medicaid Fraud

The states that recovered the most Medicaid fraud in FY 2011 were:

  • California ($388.26 million);
  • Texas ($190.87 million);
  • New York ($136.44 million);
  • Ohio ($82.48 million); and
  • Kentucky ($81.44 million) (FierceHealthcare, 4/3).
This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.