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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, 49 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 recertify 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. |
