State recoups $162M from Medicaid fraud probe, new report shows

State recoups $162M from Medicaid fraud probe, new report shows

NAPLES — The state recouped $162 million from Medicaid fraud investigations last year, a 47 percent increase from $110 million that was recovered in 2011, according to new data released Thursday.

The state Agency for Health Care Administration and the Attorney General’s Office released its annual Medicaid fraud report, which details their combined handling of complaints and investigations of Medicaid fraud.

The probes include false payments, double billing and claims for services never rendered to clinics, surgery centers, pharmacies, nursing homes and hospitals.

Of the total recovered last year, $144 million was recouped as a result of civil settlements from whistle-blower cases filed under the state’s False Claims Act. The rest was recovered from criminal investigations.

The state’s $22 billion Medicaid program is the fourth largest in the United States and serves 3.3 million Floridians who are low income, disabled or elderly. The Medicaid program is one-third of the state’s budget.

Fraud in the Medicaid system is significant. The state has 210 full-time employees assigned to the fraud unit and spent $16.7 million last year on investigations.

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