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Arizona Attorney General’s health care fraud, abuse section ranked second highest in the nation

Improved upon third place ranking in previous year

Posted 12/31/19

The Office of the Arizona Attorney General’s Medicaid Fraud Control Unit is ranked second highest in the nation according to data provided to the U.S. Department of Health and Human Services. …

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Arizona Attorney General’s health care fraud, abuse section ranked second highest in the nation

Improved upon third place ranking in previous year

Posted

The Office of the Arizona Attorney General’s Medicaid Fraud Control Unit is ranked second highest in the nation according to data provided to the U.S. Department of Health and Human Services.

MCFU, housed in the Criminal Division of the Attorney General’s Office, is also commonly referred to as the Health Care Fraud and Abuse section in Arizona, according to a press release.

The Arizona Attorney General’s Office was ranked third highest in the nation in the previous year based on data provided to HHS.

Earlier this year, the HHS published its MFCU statistical summary for Fiscal Year 2018, which listed the number of indictments obtained by each of the nation’s 50 MFCU’s. Adjusting for differences in staff size, Arizona’s MCFU emerged as the second most productive in obtaining criminal indictments, the press release stated. In FY 2017, the unit was ranked third in the nation for most indictments/convictions per capita.

“The Arizona Attorney General’s Office is a shining example nationwide for prosecuting criminals who commit Medicaid fraud against the government,” said Attorney General Mark Brnovich, in a prepared statement. “Since 2015, our dedicated team has been among the top three productive units in the country in terms of bringing criminal charges against those that commit Medicaid fraud and abuse patients cared for in Medicaid-funded facilities and has returned millions of dollars to taxpayers.”

In FY 2018, Arizona’s MCFU initiated over 200 investigations and indicted 83 individuals; 74 for fraud and nine for abuse/neglect. Also during the same year, 63 individuals were convicted; 56 for fraud and seven for abuse/neglect, according to statistical data. HCFA’s 27 employees were able to recover $11,973,830 in fraudulent funds that were returned to the government.

In addition to being ranked second in the nation, HCFA was also ranked number one for western states. The rankings are determined by statistical data comparing the number of indictments produced by the number of staff members in each of the 50 Medicaid Fraud Control Units in the country.

HCFA also participated with other states’ MFCUs and the United States Department of Justice in 55 civil cases that targeted national health care and pharmaceutical companies alleged to have engaged in improper trade practices in FY 2019. In FY 2019, six cases reached settlements.

As a result of HCFA’s participation, $6,340,085 was recovered from these companies and returned to the government, with $1,996,692 provided directly to the Arizona AHCCCS program and $4,343,393 returned to the federal government, the press release stated.

MCFU is a federally funded unit charged with investigating and prosecuting Medicaid fraud, fraud in the administration of the Medicaid program, abuse, and neglect or financial exploitation occurring in Medicaid facilities or committed by Medicaid providers or their employees.

During FY 2019, HCFA received 159 allegations/complaints regarding fraud, patient abuse, and the financial exploitation of vulnerable adults. As a result, 129 new cases were opened for investigation, including 109 fraud cases and 20 patient abuse/financial exploitation cases. HCFA improved upon their 2018 numbers and charged 100 defendants and convicted 72 defendants last fiscal year.

If anyone believes they or someone they know hasArizona Attorney General’s health care fraud, abuse section ranked second highest in the nation been the victim of or have information of Medicaid fraud, fraud in the administration of the Medicaid program, and abuse, neglect or financial exploitation occurring in Medicaid facilities or committed by Medicaid providers or their employee, they can fill out a complaint form here.