Medicaid Fraud Control Unit
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News Miami Speech Language Pathologist Arrested for Defrauding Medicaid Out of More Than $586,000
Citrus County Occupational Therapy Assistant Arrested for Defrauding Medicaid of more than $450,000
Attorney General s Medicaid Fraud Control Unit Tops $400 Million in Recoveries Since 2007
The Florida Attorney General’s Office has been investigating and prosecuting Medicaid fraud since the unit became part of the Attorney General’s Office in July 1994. The Florida Medicaid Fraud Control Unit (MFCU) investigates and prosecutes fraud involving providers that intentionally defraud the state’s Medicaid program.
The most common schemes involve doctors, dentists, clinics and other health care providers billing for services never performed, over billing for services provided, or billing for tests, services and products that are medically unnecessary. MFCU investigations involve a wide range of misconduct originating primarily from fraudulent billing schemes. Examples include phantom billing, where the medical provider bills for services not rendered, and up-coding, where a medical provider bills for providing a costly medical service when only a less expensive procedure was performed.
In addition to investigating fraud committed by health care providers, MFCU also investigates the abuse, neglect and exploitation of the elderly, ill and disabled residents of long-term care facilities such as nursing homes, facilities for the mentally and physically disabled and assisted care living facilities. The investigation of corruption in the administration of the Medicaid program is another important responsibility of MFCU.
In these tough fiscal times, we need to ensure that every dollar spent on Medicaid goes to Floridians in need – not to criminals who exploit the system.
— Florida Attorney General Pam Bondi
While committing significant resources to protect the public, the Attorney General’s Office welcomes the assistance of citizens in fighting health care fraud. Under Florida’s False Claims Act, people who blow the whistle on Medicaid Fraud are entitled to share in any funds recovered by the state.
To report fraud or abuse, individuals may use the statewide hotline number or contact the Medicaid Fraud Control Unit nearest them:
Tallahassee
(850) 414-3300 Orlando
(407) 999-5588 Tampa
(813) 287-7940 Ft. Lauderdale
(954) 712-4600 Miami
(305) 377-5441 Jacksonville
(904)-858-6919 West Palm Beach
(561) 837-5000 Pensacola
(850) 595-6057 The hearing impaired may now report Medicaid Provider Fraud Monday through Friday, 7:30 a. m. to 4:30 p. m. , by contacting the Medicaid Fraud Control Unit at (850) 414-3935 (voice TTY) or through the Florida Relay at 1-800-955-8771 (TTY)
Quick Fact:
The Florida Attorney General’s Office Medicaid Fraud Control Unit has recovered more than $490 million since 2007.
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Florida Toll Free Numbers:
- Fraud Hotline 1-866-966-7226
- Lemon Law 1-800-321-5366
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