Why OIG Did This Review
- The Department of Health and Human Services Office of Inspector General (OIG) is the designated Federal agency that oversees State Medicaid Fraud Control Units (MFCU).
- This MFCU fiscal year (FY) 2025 annual report highlights case outcomes and other data trends related to investigations and prosecutions that the 53 MFCUs conducted.
- The report’s webpage also identifies beneficial practices from prior OIG onsite reports that may be useful to other MFCUs.
What OIG Found
MFCUs recovered $4.64 for every dollar spent by States and the Federal Government. Combined recoveries from criminal and civil cases totaled almost $2 billion for FY 2025. Criminal recoveries from convictions totaled $1.3 billion and civil recoveries totaled $706 million. MFCUs also reported 674 civil settlements and judgments for FY 2025. Pharmaceutical manufacturers accounted for more…
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