State Medicaid Fraud Control Units

Objective

To investigate and prosecute Medicaid provider fraud as well as patient abuse or neglect in health facilities and board and care facilities and of Medicaid beneficiaries in non-institutional or other settings.

Who Can Apply

• State
• U.S. Territory (or Possession) Government (including freely-associated states)
• U.S. State Government (including the District of Columbia)

States, the District of Columbia, and the U.S. Territories. An established State Medicaid Fraud Control Unit must be a single identifiable entity of the State government which the Secretary certifies (and the Office of Inspector General annually re-certifies) as complying with the requirements of 1903(q) of the Social Security Act (42 CFR 1007) regarding location, function and procedure. Applicants must also comply with section 1902 (a)(61) of the Act as amended by the Omnibus Budget Reconciliation Act of 1993. Tribes (American Indian/Alaskan Native/Native American) are not eligible to apply.

Who Benefits

• State

Grantees are State entities.

Assistance Types

• Grant

Program Contact

susan.burbach@oig.hhs.gov
202-731-8516