Keep in mind that none of the States Child Welfare programming was included in this data match program. The reason why is the State Attorney General Medicaid Fraud Control Units never get referrals of fraud as this would be a conflict of interest in defending the contracted agencies which engage in Medicaid fraud.
The Medi-Medi program produced limited results and few fraud referrals. During 2007 and
2008, the program—in which 10 States had chosen to participate—received $60 million in
appropriations and it avoided and recouped $57.8 million. The program produced 66 referrals to
law enforcement, and law enforcement accepted 27 of these. Among the 10 participating States
collectively, each State averaged 2.8 Medicare referrals to law enforcement per year; law
enforcement accepted an average of 1.15 referrals per State per year. In comparison, each State
averaged 0.5 Medicaid referrals to law enforcement per year; law enforcement accepted an
average of 0.2 referrals per State per year. Also, State Medicaid programs received less benefit
from the Medi-Medi program than Medicare received. Of the $46.2 million total in Medicare
and Medicaid expenditures recouped through the program during 2007 and 2008, more than
three-quarters—$34.9 million—was recouped for Medicare.
HHS OIG MEdicare-Medicaid (MEDI MEDI) Data Match Program Review
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