Medicaid Fraud Control Unit
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.
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 about 10 percent of the payments made by Medicaid. If the national trends hold true for the State of Alaska, this percentage equates to millions of Medicaid dollars annually, resulting in a substantial reduction in moneys available to provide necessary medical services to needy Alaskans.
In general, fraud occurs when a provider submits a claim for payment to Medicaid when the provider knows, or should know, they are not entitled to the 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
Medicaid Fraud / Elder Abuse Complaint Form - PDF(643K)
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.
- 06/23/14 Good Faith Services Personal Care Attendants Sentenced for Falsely Billing Medicaid
- 04/30/14 Alaska Dispatch Article: Former Good Faith Services owners, employee charged with Medicaid fraud
- 04/16/14 Anchorage Physician Arrested for Fraudulently Billing Medicaid and Tampering with Physical Evidence
- 04/09/14 Alaska Dispatch Article: Medicaid fraud crackdown continues with 4 new cases associated with Good Faith Services
- 01/27/14 Municipality of Anchorage Employee Sentenced to One Year in Jail for Fraudulently Billing Medicaid $64,665.47
- 01/24/14 Medicaid Fraud Control Unit Reports 26 Convictions for Medical Assistance Fraud Since October 2013
- 10/17/13 Ongoing Investigation into Medicaid Fraud Abuse Results in Additional Charges and Conviction
- 07/09/13 Twenty-Nine Anchorage Based Personal Care Attendants and Medicaid Recipients Charged for Medical Assistance Fraud
- 06/28/13 Homer Based Personal Care Attendant Convicted for Fraudulently Billing Medicaid
- 06/05/13 Anchorage Personal Care Attendant Convicted for Fraudulently Billing Medicaid
- 05/23/13 Anchorage Personal Care Attendants Convicted for Endangering the Welfare of a Vulnerable Adult
- 05/20/13 Anchorage Property Tax Assessor Charged for Fraudulently Billing Medicaid for Over $60,000
- 05/16/13 Ranbaxy Pays $500 Million To Resolve Adulterated Drugs Claims
- 05/10/13 Personal Care Attendant Convicted for Fraudulently Billing Medicaid
- 05/09/13 Personal Care Attendant Convicted for Fraudulently Billing Medicaid
- 03/26/13 Anchorage Personal Care Attendants Convicted for Fraudulently Billing Medicaid
- 02/13/13 Anchorage Personal Care Attendants Indicted for Fraudulently Billing Medicaid
- 12/18/12 Anchorage Taxi Driver Convicted for Fraudulently Billing Medicaid
- State v. Arlene Brocales
- 06/05/14 - Information - PDF(67K)
- State v. A Loving Care PCA Agency, et al.
- 05/30/14 - Information - PDF(118K)
- State v. Claude Anderson
- 05/09/14 - Information - PDF(173K)
- State v. Agnes Francisco, et al.
- 04/22/14 - Complaint - PDF(109K)
- State v. Miki Kim
- 04/04/14 - Information - PDF(148K)
- State v. Ernesto Gamponia, et.al.
- 04/03/14 - Complaint - PDF(89K)
- State v. Domingo Contreras
- 02/11/14 - Information - PDF(62K)
- State v. Ferdie Odron; State v. Jerlyn Odron
- 02/10/14 - Information - PDF(70K)
- State v. Sammy Arbranilla Tuazon
- 01/07/14 - Information - PDF(136K)
Alaska Medicaid Fraud Control Unit
Office of Special Prosecutions and Appeals
310 K Street, Suite 300
Anchorage, AK 99501
Alaska Division of Health Care Services