The bill also would allow state Medicaid fraud control units
to investigate provider activities and delivery of health care services under any federal health care program during Medicaid fraud investigations.
9) See State Medicaid Fraud Control Units
Annual Report Fiscal Years 2004 and 2005, Department of Health and Human Services Office of Inspector General, available at http://www.
With the projected increases in expenditures and the rising number of Medicare and Medicaid program participants, the United States Department of Justice (DOJ), the Office of the Inspector General of the United States Department of Health and Human Services (OIG) and state Medicaid Fraud Control Units
(MFCU) continue to expend significant resources pursuing fraud and abuse.
Local law enforcement is rarely involved in nursing home abuse cases because reporting is so inconsistent, and state Medicaid Fraud Control Units
(MFCUs) (usually part of the attorney general's office), which investigate abuse allegations if they involve criminal activity in the Medicare/Medicaid program, have to rely on cases referred by state survey agencies, which restrict what is reported.
One has been provided by the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA), which authorizes state Medicaid Fraud Control Units
(MFCUs) to also investigate nursing homes for Medicare fraud.