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Nancy  Madsen
By Nancy Madsen April 2, 2012

Medicaid fraud unit has been expanded

When Gov. Bob McDonnell ran for office in 2009, he promised to crack down on Medicaid fraud.

"We will increase resources for the Commonwealth's Medicaid Fraud Control Unit at the
Attorney General's Office," he said in his health-care plan.

The unit investigates and prosecutes insurance fraud against Medicaid, the health-care program for the needy funded by federal and state governments. The group had its largest criminal and civil recoveries in fiscal 2008 under the watch of McDonnell, who was then attorney general. It collected $541 million for the federal and state governments, much of it coming from a settlement with Purdue Frederick, the manufacturers of the painkiller OxyContin. The company acknowledged it concealed the addictive powers of the drug.

A study of benefits paid during fiscal 2009 found that Virginia's Medicaid program made improper payments of $39 million, including $20.2 million from fraud. The state blocked up to $50.3 million in payments for improper claims, according to the Joint Legislative Audit and Review Commission.

When McDonnell became governor in January 2010,  the unit had 52 employees. He has worked with Attorney General Ken Cuccinelli to increase the staff to 83 workers in the current budget.

The federal government pays 75 percent of the unit's cost and the state pays the rest.

McDonnell is using money from the federal government's $600 million Oxycontin settlement to pay for Virginia's share of the expansion. The state received a $60 million slice of money and put aside $39.8 million for the fraud unit.

So resources at the Medicaid Fraud Control Unit have increased under McDonnell and we rate this a Promise Kept.

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