Tag Archives: National Association of Medicaid Fraud Control Units

MEDICAID AUDITING COSTS PER CAPITA

Most states spend around $1 dollar per capita for Medicaid Fraud Control Units.   If we compare the data on Medicaid Fraud Unit cost from the  National Association of Medicaid Fraud Control Units (NAMFCU), and then compare to population, we can see that there is a giant range.

Medicaid_Audits_UNIT_COSTS_PER_CAPITASource: Barraclough analysis using census data and data from National Association of Medicaid Fraud Control Units (NAMFCU).

Most states spend around $1 per capita on combating fraud in Medicaid.  There are exceptions:  The District of Columbia towers above all states with an expenditure of $5 per capita, followed by 3 for New York, and $2 dollars per capia for Delaware and Alaska.

DOCTORS PER MEDICAID AUDITOR UNEVEN FROM STATE TO STATE

How many doctors are there per Medicaid auditor in a state?  Perhaps the higher the number of doctors per auditor, then the less of a chance of getting audited?

If we compare data on the number of doctors for each state, and then compare it to data from the  National Association of Medicaid Fraud Control Units (NAMFCU), we can see that there is a giant range.

Medicaid_Audits_MDperAuditorSOURCE: Barraclough Analysis with data from Kaiser and National Association of Medicaid Fraud Control.

Massachusetts, Nevada, and Minnesota have more than twice the national average.   Idaho, Maine and Mississippi have the least doctors per auditor, so perhaps there is a higher chance of getting audited.

What is remarkable is the extreme differences in auditing capabilities between different states.