Fighting Medicaid Fraud in Texas

Texas Makes the Case for State Fraud Fighting

Fighting Medicaid Fraud in Texas, a new report from Taxpayers Against Fraud Education Fund, authored by Jack Meyer and Chris Wolff of Health Management Associates, looks at money recovered under the Texas False Claims Act (formally titled the Texas Medicaid Fraud Prevention Act) and its federal analog, the federal False Claims Act.


The study's key findings:

  • Texas has recovered a tremendous amount of money through enforcement of the Texas Medicaid Fraud Prevention Act (TMPFA) and the federal FCA. From 2006 through 2012, Texas recovered over $821 million for state and federal taxpayers after subtracting for relators’ shares and Texas State attorney fees and costs.
     
  • Over $348 million of this amount was allocated to Texas taxpayers and over $473 million was allocated to federal taxpayers under the Medicaid state/federal share system.
    Nearly half of these recoveries – over $394 million – resulted from fraud cases in which Texas led the investigation and prosecution of the case under TMFPA.
     
  • Whistleblowers have played a critical role in these recoveries, with over $800 million of the $821 million in total state recoveries stemming from whistleblower-initiated cases.
    The total budget for the Texas Attorney General’s anti-fraud staff – which in the time frame reviewed has varied between $4.75 million and $8.45 million per year – is dwarfed by recoveries to the State generated by the work of this office.
     
  • Provisions in TMPFA requiring defendant compensation of the State attorneys’ fees and costs have brought back over $75 million to the State between 2006 and 2012.

To read the full report click here (pdf).
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