Medicaid Fraud Control Unit
The Arkansas Attorney General’s office fights Medicaid fraud by investigating and prosecuting violations of State and federal law involving Medicaid providers and the abuse or neglect of nursing home residents.
Medicaid fraud occurs when Medicaid providers use the Medicaid program to obtain money they are not entitled to.
Providers who are convicted of Medicaid fraud may lose their eligibility to be a provider in the Arkansas Medicaid Program and may have their professional licenses revoked. Convictions may also carry prison terms and large fines.
The Medicaid Fraud Control Unit accepts complaints regarding Medicaid fraud and abuse and neglect. A report can be filed here. All complaints are confidential.
The Medicaid Fraud Control Unit also monitors and takes action regarding the abuse or neglect that a Medicaid recipient may suffer in long-term health care facilities. There are times that Medicaid residents, especially the elderly, are physically and sexually abused or neglected by health care workers. Physical abuse or neglect includes anything from striking to sexually assaulting a resident, to withholding necessary and adequate food, physical care or medical attention. Financial abuse includes the misuse of a resident’s trust funds to pay for nursing home services already being paid for by the Medicaid Program or for uses of a resident’s funds not authorized by the resident or the resident’s guardian, trustee or administrator.
2015 at a Glance
- Included law enforcement officers for the first time
- Investigated more cases than ever before
- 108 new investigations involving Medicaid fraud and abuse or neglect allegations
- Opened 18 and closed 7 drug diversion cases
- 26 Criminal convictions
- 14 Medicaid fraud convictions (an office record)
- 7 Long-term care convictions
- 9 Personal care attendant convictions
2016 at a Glance
The Medicaid Fraud Control Unit obtained more Medicaid fraud convictions with 21 total convictions and opened more criminal investigations in 2016 than ever before.
- 17 Medicaid fraud convictions
- Opened a record 112 criminal investigations
- 3 Long-term care convictions working with prosecutors
- 1 Drug diversion case closed
Attorney General Rutledge launched the Arkansas Cooperative Disability Investigations (CDI) Unit in August 2015 to fight Social Security disability fraud across the state. CDI is a joint effort among federal and state agencies to effectively pool resources for the purpose of preventing fraud in the disability programs administered by the Social Security Administration and related programs.
Arkansas ranks in the top five among states with the highest number of Social Security Disability beneficiaries.
The CDI unit saved over $3 million to the Medicaid program by investigating Social Security Disability fraud in 2016.