New York Attorney General Andrew M. Cuomo’s Medicaid Fraud Control Unit obtained a record 148 criminal convictions in the state and recovered more than $283 million in 2009.
In Cuomo’s first three years as Attorney General, the MFCU has recovered more than $660 million in taxpayer funds.
As the largest unit in Cuomo’s division of criminal justice, the MFCU investigates and prosecutes Medicaid fraud as well as patient abuse and neglect. It also served as the model for the national Medicaid fraud control unit program.
“MFCU’s mission is clear – protect vulnerable patients from neglect and abuse while ensuring taxpayer dollars are safe and secure,” Cuomo said. “I am confident that in 2010 MFCU will continue building on this nationally recognized record of excellence.”
The information, detailed in Cuomo’s annual report, submitted Tuesday to the Secretary of the U.S. Department of Health and Human Services, shows the MFCU’s major criminal and civil cases for the past year and the $283 million in recoveries.
The MFCU was awarded the Inspector General's 2009 Cooperative Achievement Award in recognition of its work on a civil settlement with Eli Lilly over allegations that the company illegally promoted Zyprexa for off-label uses. New York recovered $91 million in that settlement.
The MFCU's Operation Home Alone, meanwhile, investigated corruption in the home care industry during 2009, resulting in civil settlements with licensed home healthcare services and certified home healthcare agencies totaling $51.7 million and 25 criminal convictions.
Other cases, settlements, convictions and achievements described in the report include pharmaceutical settlements, drug diversion and prescription fraud, program fraud, nursing home lawsuits, dentistry fraud and hidden surveillance cases.
Under the federal legislation that created the Medicaid fraud control unit program in 1978, the federal government funds 75 percent of Medicaid fraud control units’ budgets and states fund 25 percent. The HHS administers the federal grant funds for the nation’s 50 Medicaid fraud control units.