California referred relatively few Medicaid fraud cases for criminal investigation in recent years, as the state has become a hot spot for healthcare fraud, rivaling other fraud-fraught jurisdictions.Over the past five years, California Medicaid oversight officials referred just a few hundred credible allegations of fraud to California’s Medicaid Fraud Control Unit, the office within the state’s Justice Department that prosecutes fraud cases in its Medicaid program.Tyler Sadwith, California’s Medicaid director, testified at a House Energy and Commerce Subcommittee on Oversight and Investigations hearing Thursday that his agency forwarded 300 or so such fraud claims during this time to state prosecutors.
“But you said 300 [referrals] and I cited 700,” Rep. Randy Weber (R-TX) pressed, pointing to Sadwith’s written testimony before the committee counting more than 700 cases received by the MCFU over that five-year period.CALIFORNIA HAS ALLOWED WIDESPREAD MEDICARE FRAUD, HOUSE REPUBLICANS SAY“That’s not even a 50% success rate, is it?” Weber asked Sadwith.“We view the 300 referrals as a strong commitment to California’s rooting out bad actors in our Medicaid program,” Sadwith said.“That’s a little short of the target,” Weber said, while yielding back with witness questioning.In a social media statement following the hearing, Weber wrote, “[T]he numbers told the story.”
