At A Glance: Medicaid Fraud Control Units Fiscal Year 2018 Annual Report

Medicaid Fraud Control Units (MFCUs or Units) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. 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 2018.

Key statistics from the report include:

• 1,503 Convictions
  • 1,109 Fraud
  • 394 Patient Abuse or Neglect
• 810 Civil Settlements and Judgments
• 974 Individuals or Entities Excluded from federally funded health programs
• Civil Recoveries
  • 33% Nonglobal Cases
  • 67% Global Cases
• $314 Million Criminal Recoveries
• $545 Billion Civil Recoveries
• $859 Million Recovered
  • MFCUs recovered $2.92 for every $1 spent

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