Law enforcement nationwide recovered more than $2 billion through Medicaid fraud investigations in 2014, with New York state representing almost one-fifth of the money.
The Department of Health and Human Services inspector general released a state-by-state breakdown of money recovered by Medicaid Fraud Control Units, law enforcement tasked to act against individuals or entities taking advantage of Medicaid.
New York had the most success with more than 100 convictions. It also recovered $378 million, one and a half times more than Louisiana, which compiled the second highest total of recoveries.
“New York is considered our ‘flagship’ unit, as the federal program was modeled on a program created in New York state in the 1970s,” said inspector general spokeswoman Katherine Harris.
The average recovery for each state and the District was more than $39 million.
New York also spent $46 million in related federal grant money, more than any other state and has the largest fraud control staff in the country.Overall, the Empire State recovered $8 dollars for every dollar spent from its grant.
Louisiana recovered more than $245 million, twice as much as Texas, which had the third highest recovery total with more than $106 million.
Louisiana used significantly less related grant funding than New York and returned almost $48 for every federal fraud control unit dollar spent.
“We have been so successful because we have well-trained, experienced and aggressive staff led by Attorney General Buddy Caldwell,” said Louisiana Department of Justice spokeswoman Laura Gerdes. “He places strong emphasis on pursuing fraudulent conduct related to the theft of and the misappropriation of taxpayer dollars.”
Louisiana and New York typically produce some of the top annual returns among the states. However, as a whole, the rankings fluctuate greatly depending on when large, multi-year fraud cases close.
“You might have one mammoth case that could make it look like you worked really hard one year,” Harris said.
For example, Virginia was the top returner in 2013 with more than $1 billion in recoveries. However, the state’s recovery dropped to less than $65 million in 2014.
Montana and South Dakota tied for the least amount of convictions with only 1 each. Montana recovered a little over $438,000, the least of all the state, and South Dakota spent the least in related federal grant money with nearly $410,000.
Both are among the least populated states and have a fraction of Medicaid enrollees as New York.
