Medicare Fraud Control Units recovered $3.36 for every $1 spent investigating fraud.
Medicaid Fraud Control Units recovered more than $1 billion in Fiscal Year 2020, the Department of Health and Human Services Office of the Inspector General reported on Friday.
Of those recoveries, $855 million were from 786 civil settlements or judgments and $173 million were for criminal convictions, OIG reported, adding that the MFCUs recovered $3.36 for every $1 spent investigating fraud.
In addition, the 53 fraud units – one for each state, the District of Columbia, and Puerto Rico and the U.S. Virgin Islands -- secured 1,017 criminal convictions, 744 of which were fraud-related, and 243 of which were for patient abuse or neglect.
"Similar to previous years, significantly more convictions for fraud involved personal care services (PCS) attendants and agencies than any other provider type," the report said.
Fraud investigations also resulted in 928 people or entities to be banished from Medicare.
“Similar to previous years, significantly more convictions for fraud involved personal care services (PCS) attendants and agencies than any other provider type.”
OIG
John Commins is the news editor for HealthLeaders.
KEY TAKEAWAYS
Of those recoveries, $855 million were from 786 civil settlements or judgments and $173 million were for criminal convictions.
In addition, the 53 fraud units secured 1,017 criminal convictions, 744 of which were fraud-related, and 243 of which were for patient abuse or neglect.