Medicaid Criminal Investigations

The Medicaid Criminal Investigation Unit investigates fraud committed by Medicaid health care providers and the physical abuse of patients in the Medicaid-funded facilities. The unit investigates embezzlement, theft, violations of federal sanctions and the improper commingling of patients' funds in Medicaid-funded facilities.

A Medicaid provider includes any individual, corporation or other entity, and their officers and employees, paid by Medicaid for providing a health care service.

The Medicaid Criminal Investigations Unit works with N.C. Department of Justice attorneys, investigators, and auditors, all of whom are trained in the complexities of health care fraud investigation and health care fraud litigation. In addition, the unit works closely with United States attorneys, district attorneys, federal and state law enforcement agencies and private insurance company fraud units. In the past fiscal year, such collaborative work has resulted in the recovery of approximately $40 million dollars for the Medicaid Program.