Search results
The statistical information for each MFCU should be interpreted in light of the State-specific organization and authorities governing the MFCU. For more information, please contact the MFCU directly. Statistics for Each MFCU
- Data Mining Applications
Data Mining Applications. Data mining is the process of...
- Certification Letters
OIG has Federal grant oversight for the MFCUs, including the...
- Archived Transmittals
Before sharing sensitive information, make sure you're on a...
- Grant Fraud
Falsifying information in award applications (e.g....
- Data Mining Applications
It provides guidance for interactions between State Program Integrity Units (PIUs) and their Medicaid Fraud Control Units (MFCUs), and contains specific examples of actions taken by States that have created well-functioning and committed partnerships between the two entities.
Feb 11, 2013 · The distinctive legal characteristics of these regulations suggest two key principles for their interpretation. Principle 1: Interpret the regulation’s text in light of the regulation’s statement of basis and purpose (often referred to as the regulation’s “preamble”).
Feb 5, 2023 · Interpreting information is an essential problem-solving and research skill, as it allows us to make sense of the data and draw meaningful conclusions. Being able to accurately interpret information can be the difference between making a smart decision and an ill-informed one.
- Organization of Mfcus
- Staffing of Mfcus
- Responsibilities of Mfcus
A MFCU must be organized according to one of the following three options related to its prosecutorial authority: 1.The MFCU is in the office of the state attorney general or another department of state government that has authority to prosecute people for violations of criminal laws with respect to fraud and patient abuse or neglect in the provisio...
A MFCU must employ individuals from each of the following categories of professional employees, whose exclusive effort is devoted to the work of the MFCU: 1. One or more attorneys capable of prosecuting the MFCU’s health care fraud or criminal cases, giving informed advice on applicable law and procedures and providing effective prosecution or liai...
A MFCU conducts a statewide program for investigating and prosecuting violations of all applicable state laws, including criminal statutes, as well as civil false claims statutes or other civil authorities, pertaining to the following: 1.Fraud in the administration of the Medicaid program, the provision of medical assistance, or the activities of p...
This part codifies sections 1903(a)(6) and 1903(b)(3) of the Social Security Act (the Act), which establish the amounts and conditions of Federal matching payments for expenditures incurred in establishing and operating a State MFCU.
People also ask
How should MFCU information be interpreted?
What information does a Medicaid MFCU keep?
What factors will OIG consider in determining MFCU performance?
What is a Medicaid fraud control unit?
May 29, 2019 · The MFCU’s case mix, as practicable, covers all significant provider types and includes a balance of fraud and, where appropriate, patient abuse and neglect cases; Each MFCU must maintain case files in an effective manner and develop a case management system that allows efficient access to case information and other performance data;
