Medicaid fraud units recovered $415.7 million from criminal convictions and $641.5 million in civil settlements in 2022, according to a report from HHS’ Office of the Inspector General.
Nationwide, there were 1,327 criminal convictions for Medicaid fraud and 553 civil settlements, according to the report that was published March 10.
Here are the provider areas with the most dollars in Medicaid fraud recovered by the office.
- Pharmaceutical manufacturers: $253.8 million recovered from 95 civil settlements and zero criminal convictions
- Managed care organizations: $89.6 million recovered from eight civil settlements and $100 recovered from one criminal conviction
- Home health agencies: $69.1 million recovered from 31 criminal convictions and $18 million recovered from 27 civil settlements
- Hospice: $84.2 million recovered from nine criminal convictions and zero civil suits
- Retail pharmacies: $4.9 million recovered from 19 criminal convictions, and $78.6 million recovered from 30 civil settlements
- Other MD or DOs (specialty not specified): $59.1 million recovered from 16 criminal convictions and $4.7 million recovered from 15 civil settlements
- Nonresidential mental health facilities: $16.6 million recovered from 27 criminal convictions and $30.6 million recovered from 12 civil settlements
- Durable medical equipment suppliers: $43.1 million recovered from 17 criminal convictions and $2.6 million recovered from 18 civil settlements
- Personal care services agencies: $38.2 million recovered from 31 criminal convictions and about $185,000 recovered from two civil settlements
- Other nonresidential facilities: $36,315 recovered from six criminal convictions and $30.4 million recovered from six civil settlements
See the full report here.
