Skip to main content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.


The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Medicaid Fraud Control Units Fiscal Year 2016 Annual Report


The Department of Health and Human Services (HHS) OIG is the designated Federal agency that oversees State Medicaid Fraud Control Units (MFCUs or Units). This MFCU Fiscal Year (FY) 2016 Annual Report highlights statistical achievements from the investigations and prosecutions the 50 MFCUs conducted for FYs 2012 through 2016. The report also identifies beneficial practices noted in OIG onsite review reports.


We based the information in this report on our analysis of FYs 2012 through 2016 statistical data submitted by the 50 MFCUs, as well as materials MFCUs submitted to OIG for recertification.


In FY 2016, Units reported 1,564 convictions, over one-third of which involved personal care services attendants. Fraud cases accounted for 74 percent of the 1,564 convictions. The number of convictions related to drug diversion cases increased from FY 2015. Units reported 998 civil settlements and judgments, with settlements with pharmaceutical manufacturers making up almost half of Unit settlements. Units also reported almost $1.9 billion in criminal and civil recoveries.

In FY 2016, Units continued a trend of increasing numbers of convictions, and civil settlements and judgments reached a 5-year high. The number of OIG exclusions resulting from Unit conviction referrals decreased slightly in FY 2016, as compared to the previous two FYs.