New Record For Medicaid Fraud Recoveries

Deputy Attorney General William Comiskey today announced that Attorney General Spitzer’s Medicaid Fraud Control Unit (MFCU) has secured record levels of recoveries for the third year in a row.

In federal fiscal year 2006, which ended on September 30, 2006, MFCU recovered more than $243.6 million for the Medicaid program and other victims of fraud. This information was included in a report made to the federal Office of the Inspector General of the U.S. Department of Health and Human Services.

These recoveries beat the prior national record - set last year by New York State’s MFCU - by more than $24 million.

Spitzer noted that the restitution numbers tell only part of the story at MFCU. He said many cases lead to program reforms that eliminate abusive billing practices and result in substantial additional reductions in Medicaid expenditures over time.

MFCU also reported a record number of successfully completed cases for 2006, which totaled 310. These cases consisted of criminal convictions of 107 persons and civil settlements or judgments with 203 persons or entities.

For fiscal years 1999 - 2006, MFCU has recovered nearly $691 million, compared to recoveries totaling $70 million between 1991 and 1998.

New York’s MFCU is the oldest and largest statewide operation in the nation dedicated exclusively to the investigation and prosecution of health care fraud and abuse, and served as the federal statutory model for the national Medicaid Fraud Control Unit Program. The unit is a branch within the Criminal Division of the Attorney General’s Office. Federal legislation currently provides 75 percent of the funding for the unit’s activities.

MFCU maintains a hot line for individuals to use to report Medicaid and insurance fraud as well as nursing home patient abuse, which is (866) NYS-FIGHT.

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