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

Tags: Healthcare, Medicaid Fraud

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