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Virginia’s Medicaid fraud control unit named best in nation

mark herringThe Virginia Medicaid Fraud Control Unit (MFCU) of the Office of the Attorney General has won the Inspector General’s Award for Excellence in Fighting Fraud, Waste, and Abuse, an award presented annually to the nation’s top MFCU by the U.S. Department of Health Office of the Inspector General (OIG.)

In 2013, MFCU broke its own record for the largest case ever investigated by a state agency for its $1.5 billion case against Abbott Labs for improperly marketing and promoting the prescription drug Depakote. Virginia’s MFCU previously won the OIG Award in 2008 following a similar case against Purdue Pharma which was the largest ever at the time. The award was presented to Virginia MFCU Director Randy Clouse today during a ceremony at the U.S. Department of Health in Washington.

“Virginians should be proud that they have a nationally renowned agency protecting their tax dollars, as well as the health of needy Virginians,” said Attorney General Mark Herring. “This award is proof that Virginia’s MFCU team and its director Randy Clouse are setting the standard for creativity, collaboration, and tenacity in going after providers who would weaken our Medicaid program through fraud or abuse.”

Criteria for the OIG Award of Excellence include the MFCU’s impact as measured in monetary recoveries and convictions, but also the use of innovative investigative and prosecutorial techniques and the MFCU’s success in collaborating with the OIG Office of Investigations, State Medicaid agency, and other law enforcement partners.

In nominating Virginia’s MFCU for this award, the Office of the Inspector General pointed out the unit’s strong partnerships and collaborative work with the Virginia Department of Medical Assistance Services, the Offices of the United States Attorney for the Eastern and Western Districts of Virginia, the Federal Bureau of Investigation, the Internal Revenue Service’s Criminal Investigation Division, the Virginia Department of Health, the Virginia Department of Social Services, and the United States Department of Health and Human Services’ OIG.

The Virginia Medicaid Fraud Control Unit (MFCU) of the Office of the Attorney General was certified in 1982, by the United States Department of Health and Human Services. The MFCU has a staff of 96 employees, including criminal investigators, auditors, attorneys and support staff who work together to develop investigations and prosecute cases. The Virginia MFCU works regularly with federal, state and local law enforcement agencies to combat fraud, protect Virginians enrolled in the Medicaid program, and save taxpayer dollars. Since 1982, the MFCU has more than $1.8 billion in criminal and civil recoveries including affirmative civil enforcement cases (ordered and collected reimbursements, fines and restitutions.)

augusta free press
augusta free press