OIG’s Medicaid Fraud Control Unit’s FY 2015: 6 things to know

HHS’ Office of the Inspector General has released its Medicaid Fraud Control report for fiscal year 2015.

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Below are six findings from OIG’s report:

1. In FY 2015, combined federal and state expenditures for the Medicaid fraud control units totaled approximately $251 million, $188 million of which were federal funds.

2. The units reported 1,553 convictions, 731 civil settlements and $744 million in criminal and civil recoveries nationwide.

3. Roughly one-third, or 483 of the 1,553 convictions, were of personal care services attendants or other home healthcare aides. Eleven percent of convictions were of nurse aides.

4. Approximately 71 percent of all convictions involved Medicaid fraud.

5. The number of convictions over the last five years have increased, while the number of civil settlements and the number of recoveries have decreased.

6. FY 2015 saw the highest number of convictions since 2011.

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