The Attorney General’s MFCU is the oldest and largest statewide operation in the nation dedicated exclusively to the investigation and prosecution of health care crime. The 300-member MFCU is responsible for monitoring the more than $25 billion annually spent on Medicaid in New York State – more than 15% of the nation’s total. The Unit - originally known as the Office of the New York State Special Prosecutor for Nursing Homes, Health, and Social Services - was created in January 1975 following the revelation of widespread and shocking abuses plaguing the State’s nursing home industry. The exposure of these scandals in late 1974 by the Temporary State Commission on Living Costs and the Economy, and by the media – including several intensive investigative projects by the New York Times, Village Voice and WNEWTV – drew national attention to the fact that millions of Medicaid dollars earmarked for the care of elderly and indigent patients were instead lining the pockets of greedy and politically influential nursing home owners and operators.
In October 1977, Congress, citing the success of the New York Unit, created the federally funded Medicaid Fraud Control Unit Program to encourage other states to "help establish Medicaid Fraud Control Units patterned after the successful unit in New York." Since the inception of this pioneering program, the 48 Medicaid fraud control units presently operating around the country have obtained over 9,000 convictions, recovered hundreds of millions of dollars in restitution, and have prevented the loss of many more billions of dollars in Medicaid overpayments.
In 1982, the U.S. House of Representatives’ Select Committee on Aging, in an extensive study of the various states’ Medicaid fraud control efforts, found that the New York Unit was "the best in the nation" and had "provided the nation with a model of state enforcement effort." The Committee also found that New York’s MFCU had "changed New York from the least effective to the most effective state in terms of Medicaid (fraud) detection and prosecution."
In 1995, the MFCU was incorporated more directly into the Attorney General’s Office and placed within its Criminal Division. As such, the MFCU continued to successfully prosecute some of the largest and most sophisticated frauds ever committed against the Medicaid program. The MFCU has seven regional offices, which are located in Albany, Buffalo, Long Island, New York City, Pearl River, Rochester, and Syracuse. In addition, the MFCU has two specialized units operating out of New York City – the Civil Unit and the Appeals Unit – as well as the statewide Special Projects Division headquartered in Pearl River. Federal legislation currently provides 75% funding for the Unit’s activities.
Since its inception, the MFCU has prosecuted nearly 3,000 defendants for Medicaid fraud and related crimes and has achieved over a 91% percent conviction rate. The Office has been responsible for the recovery of more than $326 million in overpayments, fines, and restitution.
Office of the Attorney General
120 Broadway, 13th Floor
New York, NY 10271
212-417-5250