The Alaska Medicaid Fraud Control Unit (MFCU) has been part of the Attorney General's Office since January 1992. The unit is located in Anchorage and has statewide jurisdiction. It has the responsibility for investigating and prosecuting Medicaid fraud and the abuse, neglect or financial exploitation of patients in any facility that accepts Medicaid funds. The Director of the MFCU is Assistant Attorney General Donald R. Kitchen, a career criminal prosecutor with more than a quarter century of experience in the criminal justice system. There are 47 MFCU's across the U.S.
Although the vast majority of health care providers are honest and dedicated to providing the highest quality health care to their patients, Medicaid provider fraud costs American taxpayers hundreds of millions of dollars annually and threatens the integrity of the Medicaid program. Nationally, it is estimated that Fraud, Waste and Abuse account for 10 to 20 percent of the payments made by Medicaid. If the National trends hold true for the State of Alaska, these percentages equate to 30 million to 70 million Medicaid dollars annually, resulting in a substantial reduction in moneys available to provide necessary medical services to needy Alaskans.
Fraud is "intentional" deception or misrepresentation which results in an "unearned benefit", usually in the form of an excess payment. While health care fraud can take many forms, the most common involves billing for services not performed or billing for more expensive services than those actually provided. Medicaid patients may not suspect fraud, as they are seldom made aware of the procedures or dollar amounts billed to Medicaid. An unscrupulous provider can generate a fraudulent Medicaid payment simply by filing a false claim with an eligible recipient's identification number and a valid procedure code.
Message Hotline to Report Medicaid Fraud 1-907-269-6279
- Examples Of Fraud Schemes In Health Care:
- Billing for services not rendered
- Billing for higher level of services than actually performed
- Billing for more services than actually performed
- Charging higher rates for services to medicaid than others
- Coding billings to get more reimbursement
- Providing and billing for unnecessary services
- Misrepresenting an unallowable service in a Medicaid billing
- Falsely diagnosing so Medicaid will pay for more services
If you suspect Medicaid health care fraud or patient abuse, do your part to protect the integrity of the Medicaid program and the public resources that fund it! Contact the Medicaid Fraud Control Unit Hotline at 1-907-269-6279 and ask to speak to an investigator or simply leave a message. Our fax is 1-907-269-6202. Or call the Crimestoppers Hotline at 1-907-561-7867. You need not give your name and you may be eligible for a reward.
Alaska Medicaid Fraud Control Unit
Office of Special Prosecutions and Appeals
310 K Street, Suite 308
Anchorage, AK 99501
email at medfraud@law.state.ak.us
Additional Resources:
Alaska Division of Health Care Services
