Attorney General Announces The Medicaid Fraud Control Unit Recovered A Record Amount From Its 2008-2009 Efforts

DENVER — Colorado Attorney General John Suthers announced today that his office’s
Medicaid Fraud Control Unit has recovered a record amount of money from Medicaid fraud settlements and restitution during the fiscal year ending June 30 totaling more than
$5.3 million.

“The Medicaid Fraud Control Unit’s efforts this year have delivered tremendous results for the people of the state Colorado,” Suthers said. “The unit’s work also serves as a warning to those who are considering ripping off Colorado’s Medicaid program. If you abuse the public trust, we will hold you accountable.”

The high recovery amount is the most money the Medicaid Fraud Control Unit has taken in since 1983, according to Department of Law records. The total, however, likely is the most money the unit has collected since its formation in 1978, though records were not available for the years 1978 to 1983.

The money, received in civil settlements and criminal restitution, compensates the state for Medicaid payments made to providers as the result of fraud, waste and abuse of public funds.

The amounts collected each fiscal year have steadily increased over the past decade. The bulk of the money came from interstate “global” settlements typically made between large companies and the federal government in conjunction with some or all of the states.

The Medicaid Fraud Control Unit is a 14-employee unit within the Criminal Justice Section of the Office of the Attorney General. Its staff includes two criminal prosecutors, eight investigators, an auditor and a registered nurse investigator. The Medicaid Fraud Control Unit is charged with investigating and prosecuting fraud committed by providers against the state Medicaid system and other government healthcare programs, as well as physical and financial abuse of persons in federally funded long-term care.

Three-fourths of the unit’s $1.467 million budget comes from federal funds. The state contributed $364,267 to the unit’s budget for the 2008-2009 fiscal year, compared to
$5.3 million recovered for state coffers.

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