How do Medicaid fraud cases typically arise?
While specifics may vary from state to state, a primary source of referrals is the single state agency responsible for auditing and reviewing Medicaid provider claims. Another significant source of referrals is MFCUs in other states, which identify fraudulent practices in a particular type of health care service, for example, a national corporation that is submitting false claims for services not provided. Finally, multi-state global settlements may be initiated by the Department of Justice.
