0
0
0
s2smodern
powered by social2s

Health Care Fraud & Elder Abuse Section

The MFCU employs a professional staff of 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 our most vulnerable citizens and to save taxpayer dollars. Since 1982, the MFCU has recovered more than $800 million in criminal and civil recoveries including affirmative civil enforcement cases (ordered and collected reimbursements, fines and restitutions). In 2008, the Virginia MFCU was named the number one MFCU in the country by the United States Department of Health and Human Services, Office of Inspector General. The MFCU is proud to serve among the nation's leaders in combating fraud in the Medicaid program.

The Unit is charged with the investigation and prosecution of Medicaid providers who conduct their businesses in a fraudulent manner. The intended result of this effort is to deter all providers of medical services from engaging in fraudulent or abusive behavior.
In order to achieve this goal, the Unit will:

  • Conduct professional and timely criminal investigations that lead to just results.

  • Collaborate with other state and federal agencies involved in the battle against healthcare fraud and patient abuse and neglect. In fact, the MFCU is uniquely positioned to take the lead in investigating and prosecuting healthcare fraud and patient abuse and neglect in the Commonwealth

  • Seek alternatives to criminal prosecution, when appropriate, to reinforce and instill in the provider community a desire to comply with all regulations promulgated by the Department of Medical Assistance Services (DMAS)

  • Refine internal operating procedures designed to produce timely investigative results and maximize Unit resources in order to promote efficient and thorough strategies for each case

  • Promote effective communication between the Unit and DMAS, thereby increasing the number and quality of referrals

  • Maintain the highest standards of excellence through aggressive training on current fraud trends and law enforcement tools in an attempt to better combat fraud in the Medicaid program

  • Provide assistance related to nationwide civil and criminal healthcare fraud matters.

 

Randall L. Clouse

Director and Chief

Health Care Fraud & Elder Abuse Section

Office of the Attorney General
202 North Ninth Street
Richmond, VA 23219