View Reports by Status
  • Published
  • Pending
  • Overdue
  • 2.
    Search Reports
    Register to receive report status email notification.

    Document Summary
    - Report Published -

    Report Document No. 61

    Document Title
    Office of the Attorney General of Virginia 2011-2012 Annual Report - Medicaid Fraud Control Unit

    Office of the Attorney General and Department of Law

    Enabling Authority
    Appropriation Act - Item 60 (Special Session I, 2012)

    Executive Summary
    To the citizens of the Commonwealth:

    The purpose of my office’s Medicaid Fraud Control Unit (MFCU) is to investigate and prosecute unscrupulous health care providers who commit fraud against Virginia’s Medicaid program and Virginia taxpayers by billing for services not rendered, not using properly trained and certified employees, or abusing or neglecting the patients in their care.

    This year, as a result of our criminal and civil investigations, the Virginia MFCU has successfully recovered a significant amount of dollars from providers who defrauded or attempted to defraud the Medicaid program. I am pleased to report the unit has obtained convictions of 21 health care providers in state and federal courts, with $40,260,842.92 in restitution ordered to be returned to Medicaid.

    The MFCU’s outstanding performance is attributable to a focused team effort, exceptional working relationships with other state and federal agencies, and the selfless dedication of the men and women of the unit. These employees spend many days away from home and family to conduct surveillance, execute search warrants, analyze records, conduct interviews, and prosecute cases in court. As a result, in 2008, the unit was named the number one MFCU in the country by the U.S. Department of Health and Human Services and the U.S. Office of Inspector General.

    In response to the continued increase in referrals of suspected fraud, this year I authorized the MFCU to request additional funding from the U.S. Department of Health and Human Services for an additional 10 investigators, attorneys, and support staff. We anticipate that as a result of this staffing increase, the Unit will recover millions of additional dollars in fraudulently obtained Medicaid funds.

    In addition to preventing fraud, one of my key priorities is to protect the elderly and the incapacitated from abuse and neglect. As part of our recent MFCU expansion, I hired additional investigative staff, including registered nurses, to increase our ability to investigate and prosecute abuse and neglect cases in health care facilities and homes. As a result of community outreach efforts, MFCU Outreach Coordinators, working with local law enforcement, provided information on ways to prevent, recognize, and report elder abuse and neglect at over 150 community events.

    The following report reviews the first half of the 2012-2014 biennium, from July 1, 2011, to June 30, 2012, and sets forth the organization, operations, and accomplishments of the unit.

    With kindest regards, I remain,

    /s/ Kenneth T. Cuccinelli, II
    Attorney General of Virginia