NC Recovers $20 Million, Obtains 16 Criminal Convictions in 2007 Medicaid Fraud Cases
North Carolina’s Medicaid fraud investigators recovered more than $20 million from cases of fraud and patient abuse in 2007. The Medicaid fraud unit investigated and closed 56 cases of fraud and patient abuse between October 1, 2006, and September 30, 2007. Investigations led to 16 criminal convictions and 10 civil settlements that recovered more than $20 million from Medicaid providers. Of that total, $3.7 million in Medicaid penalties went to local public schools, with the bulk of the remainder going to the state and federal Medicaid program. The NC Medicaid Investigations Unit investigates fraud and abuse of Medicaid payments to nurses, doctors, hospitals, pharmacies, and other health care providers, and also investigates patient abuse and neglect in nursing homes and other Medicaid-funded facilities.
To continue these efforts, the legislature recently funded five new positions for the Medicaid Investigations Unit, including three new investigators and one new attorney. The unit is also in the process of opening a branch office in Charlotte to cover western North Carolina and Mecklenburg County, which has the highest total dollars in Medicaid provider payments of any county in North Carolina.
Physical Address: 301 Fayetteville Street, Suite 1900, Raleigh, NC 27601