Sohail's staff members contacted Medicaid Fraud Control Unit
and informed them the pediatrician was planning to shred patient files related to the fraudulent vaccine administrations.
While inspectors general and Medicaid officials are responsible for preventing and investigating fraud and abuse, they also refer certain cases to the state Medicaid Fraud Control Unit
. Typically located within the Office of Attorney General, Medicaid Fraud Control Units
are responsible for conducting criminal investigations and prosecuting providers suspected of fraud, fraud in the administration of the Medicaid program, and physical abuse in Medicaid-funded facilities.
Department of Health and Human Services threatened to cut off funding to the state Attorney General's Medicaid Fraud Control Unit
unless the office quit showing Nalder the files.
Further, federal investigators or members of the state's Medicaid Fraud Control Unit
will be permitted to examine its financial records or other documents to determine whether the facility has complied with the terms of the settlement.
"This settlement restores funding to the Arkansas Medicaid program, and I am grateful for the work done by our Medicaid Fraud Control Unit
, other states and the federal government on behalf of Arkansas taxpayers and Medicaid beneficiaries."
They include HHS's OIG, the FBI, the federal Department of Justice, and each state's Medicaid Fraud Control Unit
(which have civil and criminal authority).
The Attorney General's Medicaid Fraud Control Unit
(MFCU) found that the nursing homes had routinely billed Medicaid for reserved beds when their vacancy rates exceeded 5 percent.
Next, attorneys were designated to work with MPI and the, Attorney General's Medicaid Fraud Control Unit
(MFCU) to help prosecute the cases MPI developed.
The IG's office would be able to recover or freeze Medicaid funds from providers if they've committed fraud, and will be required to refer suspected fraud or criminal activity to the state attorney general's Medicaid Fraud Control Unit
. The office will also be required to file a yearly report on its investigation and money recovered.
"Not since the dark days of New York's nursing home scandal in the mid-1970s has my office seen such a betrayal of patient trust as displayed in this case," Jose Maldonado, director of the attorney general's Medicaid fraud control unit
, was quoted as saying.