MFCUs rack up nearly $2B in criminal and civil cases
By HME News Staff
Updated 10:54 AM CDT, Mon March 23, 2026
WASHINGTON – The Medicaid Fraud Control Units (MFCUs) recovered $4.64 for every dollar spent by states and the federal government in fiscal year 2025, according to an annual report.
Other highlights from the report:
- MFCU combined recoveries from criminal and civil cases totaled almost $2 billion. Criminal recoveries from convictions totaled $1.3 billion and civil recoveries totaled $706 million.
- MFCUs also reported 674 civil settlements and judgments for FY 2025. Pharmaceutical manufacturers accounted for more civil settlements and judgments than any other provider type. MFCUs reported 1,185 convictions. MFCU cases resulted in 856 convictions for fraud and 329 convictions for patient abuse or neglect. Significantly more convictions for fraud involved personal care services attendants than any other provider type.
- MFCU convictions led to OIG exclusions of 900 individuals and entities from federal health care programs, broadening the impact of MFCU convictions. For FY 2025, MFCUs reported receiving a total of 5,991 fraud referrals from managed care entities.
This year’s report highlights case outcomes and other data trends related to investigations and prosecutions by 53 MFCUs.
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