Beverly Tran on Proposed Revision of Performance Standards for State Medicaid Fraud Control Units, December 5, 2011

Never before has anyone ever spoken of Medicaid Fraud in Child Welfare with such finesse and no one else ever will because I have all intentions of running this game.

What is a Medicaid Fraud Control Unit?  According to the National Association of Medicaid Fraud Control Units, it states:

Medicaid provider fraud costs American taxpayers hundreds of millions of dollars annually and hinders the very integrity of the Medicaid program. State Medicaid Fraud Control Units (MFCUs) have long been in the forefront of health care fraud enforcement. A Medicaid Fraud Control Unit is a single identifiable entity of state government, annually certified by the Secretary of the U.S.Department of Health and Human Services, that conducts a statewide program for the investigation and prosecution of health care providers that defraud the Medicaid program. In addition, a MFCU reviews complaints of abuse or neglect of nursing home residents. A Unit may review complaints of the misappropriation of patients’ private funds in these facilities. The Unit is also charged with investigating fraud in the administration of the program and for providing for the collection or referral for collection to the single state agency and overpayments it identifies in carrying on its activities. 

The Ticket to Work and Work Incentives Improvement Act of 1999 extended the jurisdiction of the Units to allow them, with the approval of the Inspector General of the relevant federal agency, to investigate fraud in any federally funded health care program, such as Medicare. This authority is limited to those cases that are primarily related to Medicaid. This law allows the MFCUs the option to investigate complaints of abuse or neglect of those residing in board and care facilities, regardless of the source of payment.

As one can easily see, the population of child Medicaid is omitted.  This is why groups such as Children's Rights has to file lawsuits to get States to protect the children in the foster care system.

Furthermore, this is the reason why there are no statistical reports of murder, rape, torture and drugging children in foster care.  Child Welfare Services in foster care are funded through Targeted Case Management,  a.k.a. Medicaid; therefore, MFCU is suppose to investigate abuse and neglect in foster care but does not.  The typical state reaction to reports of abuse and torture in foster care is to move the child to a new placement.  Some states have special "death squads" to secretly investigate and destroy evidence of a child murder in foster care.  These reports are never made public, it is rare that anyone is prosecuted, and not one penny of Medicaid is recovered.

By not investigating abuse and neglect in foster care, a direct correlation is constructed to another neglect3ed area of regulation in Child Welfare, the contracts and services.  Here the amounts of Medicaid fraud will nationally rise into the billions.

These MFCU were created the same time of CAPTA.

Without further adieu, experience the publishing of why Medicaid Fraud in Child Welfare is the nation's dirty little secret.

Public Comment of Beverly Tran on Proposed Revision of Performance Standards for State Medicaid Fraud Contr...

Federal Register Notice: Proposed Revision of Performance Standards for State Medicaid Fraud Control Units

Stop Child Medicaid Fraud