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Alabama Medicaid Fraud Control Unit: 2025 Inspection

Issued on  | Posted on  | Report number: OEI-04-25-00400

Report Materials

OIG administers the Medicaid Fraud Control Unit (MFCU or Unit) grant awards, annually recertifies each Unit, and oversees the Units’ compliance with the requirements of the grant and adherence to 12 established performance standards that reflect practices identified by OIG and MFCUs that will improve Unit effectiveness. As part of this oversight, OIG conducts periodic onsite inspections of Units and issues public reports of its findings and observations.

Correction Notice

This report was originally issued on September 9, 2026. OIG discovered that the report contained an error in the background. We have corrected the error and issued the corrected report on September 30, 2026; please use this version. The earlier report stated “In FY 2025, Alabama’s Medicaid expenditures were approximately $8.4 million.” The correct number is “$8.4 billion.”

27-E-04-002.01 to MFCU - Open Unimplemented
Update expected on 03/08/2027
Hire additional staff in accordance with its approved budget and in relation to State Medicaid expenditures

27-E-04-002.02 to MFCU - Open Unimplemented
Update expected on 03/08/2027
Develop a plan to expand the size of the Unit

27-E-04-002.03 to MFCU - Open Unimplemented
Update expected on 03/08/2027
Update its policies to include coordinating cases with Federal partners

27-E-04-002.04 to MFCU - Open Unimplemented
Update expected on 03/08/2027
Reinforce the terms of the MOU with the PIU to increase the number of fraud referrals

27-E-04-002.05 to MFCU - Open Unimplemented
Update expected on 03/08/2027
Ensure that periodic supervisory reviews of case files are consistently documented

27-E-04-002.06 to MFCU - Open Unimplemented
Update expected on 03/08/2027
Implement a new case management system that allows for efficient access and accurate reporting

27-E-04-002.07 to MFCU - Open Unimplemented
Update expected on 03/08/2027
Improve communication with the USAO in the Southern District

27-E-04-002.08 to MFCU - Open Unimplemented
Update expected on 03/08/2027
Report all adverse actions to the NPDB within the required timeframes

27-E-04-002.09 to MFCU - Open Unimplemented
Update expected on 03/08/2027
Revise the MOU with the State Medicaid Agency to reference the CMS Performance Standard for Referrals

View in Recommendation Tracker
Report Type
Evaluation
HHS Agencies
Medicaid Fraud Control Unit
Issue Areas
Financial Stewardship Managed Care OIG Statutory Authority and Regulatory Matters
Target Groups
–
Financial Groups
Medicaid

Notice

This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.