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At A Glance: Medicaid Fraud Control Units Fiscal Year 2021 Annual Report

Issued on  | Posted on  | Report number: OEI-09-22-00020

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. The Office of Inspector General (OIG) 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 53 MFCUs submitted for fiscal year 2021.

Key statistics from the report include:

  • 1,105 Convictions
    • 780 Fraud
    • 325 Patient Abuse or Neglect
  • 716 Civil Settlements and Judgments
  • 540 Individuals or Entities Excluded from federally funded health programs
  • Civil Recoveries
    • 46% Nonglobal Cases
    • 54% Global Cases
  • $856.6 Million Criminal Recoveries
  • $826.2 Billion Civil Recoveries
  • $1.7 Billion Recovered
    • MFCUs recovered $5.36 for every $1 spent