Medicaid anti-fraud efforts recovered $25 million from SNFs in 2015

Federal authorities recovered roughly $25 million from skilled nursing facilities during criminal and civil investigations in fiscal year 2015, a new report from the Department of Health & Human Services Office of Inspector General shows.

The OIG's Medicaid Fraud Control Units annual report for FY 2015, which was published Wednesday, shows the units recovered $744 million overall in criminal and civil fraud, abuse and neglect cases over the course of the year.

Just under $25 million of that total came from cases involving skilled nursing facilities, the report shows. Nursing facilities ranked highest across all healthcare providers in total money recovered through criminal abuse and neglect and civil abuse and neglect cases, at $1.68 million and $2.84 million respectively. 

Investigations into fraud, abuse and neglect at nursing homes resulted in 40 criminal convictions and 20 settlements and judgements in FY 2015. Fraud control units reported more convictions in 2015 than the preceding five years, according to the report.

The total number of abuse and neglect convictions — the groupings that resulted in the most convictions for the skilled nursing sector — jumped from 362 to 456 in FY 2015, after declining in the previous five years, according to the OIG.

Click here to read the OIG's full Medicaid Fraud Control Units Fiscal Year 2015 Annual Report.