State Medicaid Fraud Control Units and the NAMFCU

1. State Medicaid Fraud Control
Units and the NAMFCU
Martin Milita

2. State Medicaid Fraud Control Units and
the NAMFCU
 With five years of experience as New Jersey’s Medicaid inspector general, Martin
Milita currently serves as a senior director at Duane Morris Government Strategies.
As a member of the 18-person team, he represents clients at the local, state, and
federal levels. During his time as Medicaid inspector general, Martin Milita worked
with the state’s Medicaid fraud control unit (MFCU).

3. State Medicaid Fraud Control Units and
the NAMFCU
 Established in 1978, the National Association of Medicaid Fraud Control Units
(NAMFCU) is comprised of MFCUs from 49 states and the District of Columbia.
The association is divided into six regions, each of which selects a representative
for the NAMFCU committee; the representative meets with the president, vice
president, director of the New York MFCU, and all past association presidents to
manage the association. The National Association of Medicaid Fraud Control Units
helps state MFCUs through its training programs, technical assistance, and
information sharing via the committee.

4. State Medicaid Fraud Control Units and
the NAMFCU
 As the state MFCUs are limited to investigating and prosecuting Medicaid fraud
within their borders, the association provides a way for wider ranging crimes to be
addressed. State Medicaid fraud units may also investigate non-Medicaid funded
facilities, such as assisted living homes, if those facilities are abusing or neglecting
the people in their care. MFCU performance is assessed based on a set criteria
ranging from staffing levels to the case mix of the unit—including both fraud and
abuse—to case information maintenance.