Medicaid expenditures in 2008 were Dollars 321 billion, accounting for 16% of domestic health care spending and coverage of 60 million individuals. Overall, Medicaid accounts for the second largest state budgetary expenditures (17%). In recent years, state officials have focused on identifying fraud in an effort to control Medicaid expenditures. Twenty-three states and the District of Columbia adopted state False Claims Act (FCA) legislation to facilitate fraud investigations. This legislation, modeled after federal legislation, allows private citizens, termed qui tarn relators, to file lawsuits alleging fraud by Medicaid contractors and to be awarded part of the recoveries. Historically, 90% of Medicare fraud has involved qui tarn relators, resulting in financial recoveries of Dollars 9.3 billion between 1996 and 2005. No study has reported similar data for Medicaid. We report on Medicaid FCA investigations from 1996 through 2009.
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