Medicaid Fraud By the Numbers

The Triangle Business Journal recently reported that North Carolina ranks among the top 19 states for Medicaid fraud recoveries. According to the article, which relies on a new report from the U.S. Department of Health and Human Services’ Office of the Inspector General, North Carolina ranked 9th for Medicaid fraud recoveries in 2016. A total of 387 investigations (including both fraud and abuse/neglect) resulted in 20 indictments, 25 convictions, $11.875 million in criminal recoveries, and $63.043 million in civil recoveries. In all, the Medicaid Fraud Unit recovered a total of $80.416 million.

Individuals and businesses that receive Medicaid reimbursement should appreciate that early detection and disclosure of erroneous and/or improper billing practices can be critical in resolving Medicaid fraud investigations. Proactive measures intended to identify and disclose errors can help to ensure that investigations remain civil in nature, and not criminal. By demonstrating the lack of any intent to defraud, as we have done for clients in the past, investigations can terminate without any criminal prosecution at all.

If you have learned that you or your business are under investigation for Medicaid billing fraud, and you would like to speak with an experienced white collar defense attorney, contact Dhamian Blue at Blue LLP.

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