The enactment of the Medicare and Medicaid Anti-Fraud and
Abuse Amendments of 1977 authorized the establishment of,
and Federal funding for, the State Medicaid Fraud Control
Units (SMFCUs). Currently, 47 States and the District of Columbia
participate in the Medicaid fraud control grant program through
their established SMFCU. The majority of the Units are located
within the Office of State Attorneys General. A small number
of the Units are located in various other State Agencies.
The mission of the Medicaid fraud units is to investigate
and prosecute Medicaid provider fraud and incidences of patient
abuse and neglect.
The Inspector General is delegated the authority to annually
certify each SMFCU as eligible to receive Federal grant funds
under the Medicaid fraud control program. The Medicaid fraud
units receive 90 percent Federal funding for the first 3 years
of operation and 75 percent thereafter. A primary goal of
the OIG is to ensure that each unit fully complies with all
Federal regulations governing the functions and operations
of a Medicaid fraud unit.
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