Medicaid Fraud Control Units recover about $36 million from DME in 2016

Wednesday, May 24, 2017

WASHINGTON – Medicaid Fraud Control Units made 29 criminal convictions and 56 civil settlements and judgments involving DMEPOS providers in fiscal year 2016, according to a report from the Office of Inspector General (OIG) published in May. On the criminal side, the units recovered more than $5 million; on the civil side, they recovered about $31 million. In all, the units reported 1,564 criminal convictions and 998 civil settlements and judgments, representing a total of almost $1.9 billion in recoveries. The OIG found that the units continued a trend of increasing the number of criminal convictions in 2016, and they hit a five-year high for the number of civil settlements and judgments. The OIG’s report was based on an analysis of 2012-2016 statistical data submitted by 50 units.