OIG reports $1.7 billion in Medicaid fraud recoveries in fiscal year 2021, despite pandemic challenges

Efforts by state Medicaid Fraud Control Units continued to face pandemic-related operational challenges in fiscal year 2021 but still managed to recover $1.7 billion, according to a new report.

State MFCUs secured 13 criminal convictions related to patient abuse or neglect in assisted living communities last year, recovering $60,654. Units also secured one settlement / judgment, recovering $1,000, according to the Medicaid Fraud Control Units Fiscal Year 2021 Annual Report, released Tuesday.

Comparatively, nursing facilities accounted for 11 criminal convictions that led to the recovery of $43,018, and 10 civil actions that amounted to $478,976 in recoveries.

Two criminal convictions for fraud in assisted living community-based Medicaid providers and programs also were secured, leading to the recovery of $495. Units also secured two civil settlements / judgments to recover $187,895.

There were no criminal convictions for fraud in nursing facilities, but three civil actions resulted in the recovery of $438,176.

Source: OIG reports $1.7 billion in Medicaid fraud recoveries in fiscal year 2021, despite pandemic challenges / McKnights Senior Living

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