June 18, 2013
Special Report: Medicaid Fraud in Florida
Scam Orders - Investigating Financial Fraud, Abuse and Neglect
Lilly Rockwell | 11/5/2012
Florida’s Medicaid fraud officials are assigned to investigate financial fraud and the abuse and neglect of Medicaid patients, typically in nursing homes. Florida is federally required to investigate patient abuse cases through its PANE (Patient Abuse, Neglect and Exploitation) program. In some years, nearly half of the cases referred to prosecutors are patient abuse cases, not financial fraud, such as overcharging Medicaid for services, which most people associate with health care scams.
Investigation Cases Opened
| Year | Total | Patient Abuse |
| 2006-07 | 524 | 243 |
| 2007-08 | 391 | 108 |
| 2008-09 | 372 | 100 |
| 2009-10 | 388 | 91 |
| 2010-11 | 356 | 53 |
Referrals for Prosecution
| Year | Total | Patient Abuse |
| 2006-07 | 61 | 21 |
| 2007-08 | 62 | 30 |
| 2008-09 | 70 | 29 |
| 2009-10 | 70 | 32 |
| 2010-11 | 60 | 28 |
Arrests
| Year | Total | Patient Abuse |
| 2006-07 | 111 | 24 |
| 2007-08 | 91 | 28 |
| 2008-09 | 82 | 23 |
| 2009-10 | 94 | 36 |
| 2010-11 | 90 | 27 |
Convictions
| Year | Criminal | Civil |
| 2010-11 | 85 | 44 |
| 2009-10 | 85 | 73 |
| Note: Figures based on state fiscal years, which start July 1, except for convictions. Source: Medicaid Fraud Control Unit, Agency for Health Care Administration |
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