By Nolan Mckendry | The Center Square
(The Center Square) — Louisiana has secured more than $73 million in restitution orders tied to Medicaid fraud and related cases under Attorney General Liz Murrill, but only about $14.5 million has actually been collected.
Matt Stafford, who has led the Medicaid Fraud Control Unit and was promoted to director of the new division, said collections vary significantly year to year depending on the type of case and the defendant’s ability to repay.
“Historically, our return on investment’s been really good,” Stafford said. “We have good years and bad years.”
Stafford said criminal fraud cases often involve defendants who may not have the money to repay what was stolen. Civil fraud cases, including overbilling or billing errors, can sometimes produce better recoveries because providers or companies may still have assets or continuing operations.
“Obviously if someone’s stealing money from the government, typically they don’t have a lot of money to pay back,” Stafford said. “Other times you have bigger cases — it might not be a criminal fraud. It might be a civil fraud where it was just an overbilling or an error where we can still go after those Medicaid dollars to get those recoveries back.”
The Medicaid Fraud Control Unit investigates Medicaid provider fraud and abuse or neglect involving vulnerable people in health care facilities. The unit receives referrals from the U.S. Department of Health and Human Services, the Louisiana Department of Health and other sources.
The Attorney General’s Office said the Medicaid Fraud Control Unit receives 75% of its funding from the U.S. Department of Health and Human Services, including a $10 million federal grant for federal fiscal year 2025-26. The remaining 25%, or about $3.3 million, is funded by the state.
Murrill cautioned that the restitution figure should not be mistaken for money already returned to the state.
“That does not mean that we’ve collected $73 million, so I would be clear on that,” Murrill said. “We do have orders of restitution amounting to $73 million, and we’ll continue to try and recover that money.”
The $14.5 million collected so far represents roughly 20% of the restitution ordered.
Murrill said repayment can be difficult because many defendants are removed from Medicaid work or barred from participating as providers once they are accused or convicted of stealing from the program.
“I’m sure you can understand that when people are arrested and potentially going to jail or kicked out, all of these people are then prohibited from working or being Medicaid providers, participating in the program,” Murrill said. “So it limits some of the options, but when they were stealing from the program, we certainly think it’s appropriate that they not be allowed to participate as a provider in that program.”
Murrill announced Wednesday that 21 people had been arrested on charges of Medicaid fraud or cruelty to people in need of care, part of a broader enforcement push by her Medicaid Fraud Control Unit. She also announced the unit has been elevated to a standalone division within the Louisiana Department of Justice.
Since taking office, Murrill’s office says it has indicted, arrested or charged 95 people for Medicaid fraud, abuse and neglect in residential facilities and other programmatic offenses. The office also says it has secured 105 convictions and more than $73 million in ordered restitution.
The Louisiana Department of Health said its Program Integrity Unit has reviewed more than 4,200 complaints of provider and beneficiary fraud this year, identified or recovered more than $9 million in overpayments and penalties, removed more than 100 providers from Medicaid and referred nearly 375 cases to the Attorney General’s Office for investigation and prosecution.
Murrill cast the arrests and new division as part of a larger crackdown on Medicaid fraud by state and federal officials.
“I will not stop until the people’s money is returned and those who break the law face Louisiana justice,” Murrill said. “Their tax dollars are intended for those in need. Nothing is more offensive than those who manipulate the system for their own benefit.”