Our guest for lunch this week was Dennis Pheney Jr., Michigan Assistant Michigan Attorney General for the Health Care Fraud Division. Dennis talked with us about the Health Care Fraud Division of the Michigan Attorney General’s Office. He prosecutes Medicaid Fraud on behalf of the Department of Community Health, which oversees the Michigan Medicaid Program. Providers such as medical doctors, pharmacies and home health providers can be prosecuted for filing false claims.
Healthcare fraud and abuse affects all of us. Healthcare fraud significantly impacts the Medicaid program by using up valuable public funds needed to help vulnerable children and adults access health care. Everyone can take responsibility by reporting fraud and abuse. Recent cases were cited in which false billing by unscrupulous criminals resulted n millions of dollars being paid out for services that were never performed.
Since its inception, the Health Care Fraud Division has obtained criminal restitution orders totaling $7,401,187.70; civil judgments totaling $11,082,643.53; and settlement agreements providing for the recovery of $3,137,154.65 to the Medicaid Program. In total, the HCFD has obtained court orders and settlements requiring the return of $21,620,985.88 to the Medicaid Program. Additionally, the HCFD has collected $1,131,397.15 from Medicaid providers to offset the HCFD's investigation and prosecution costs.