April 16, 2014

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

Tags: Healthcare, Medicaid Fraud

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