MCFU Not Reporting

The Virginia Medicaid Fraud Control Unit (MFCU) recovered $34 for each $1 spent on fighting healthcare fraud. However, with those stellar results, the MFCU did not report half of all convictions to OIG within required timeframes. The Unit did not report 42 of its 79 convictions to OIG within 30 days of sentencing, as required by Federal regulations.

The following table  shows how many days after sentencing these convictions were reported to OIG.

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Performance Standard 8(f) states that the Unit should transmit to OIG reports of all convictions for the purpose of exclusion from Federal health care programs within 30 days of sentencing. Late reporting of convictions to OIG delays the initiation of the program exclusion process, which may result in improper payments to providers by Medicare or other Federal health care programs or possible harm to beneficiaries.

Michael Rosen, Esq.

Written by Michael Rosen, ESQ
ProviderTrust Co-Founder, mrosen@providertrust.com

Michael brings over 20 years of experience founding and leading risk mitigation businesses, receiving numerous accolades such as: Inc Magazine’s Inc 500 Award and Nashville Chamber of Commerce Small Business of the Year
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