OFFICE OF ATTORNEY GENERAL

MEDICAID FRAUD CONTROL UNIT (MFCU)

MFCU FY2012

Total Recoveries: Total Budget:

25% State Share $97,046 75% Federal Share $291,137

$2,531,736 $388,183

Return on Investment: $6.52 per $1 spent

MFCU FY2012 Cases

Opened: Closed: Pending: 44 50 30

MFCU FY2013 (through Dec. 14, 2012)

Total Recoveries: Total Budget:

25% State Share $99,151 75% Federal Share $297,454

$7,388,048 $396,605

Return on Investment: $18.63 per $1 spent

MFCU FY2013 Cases (through Dec. 14, 2012)

Opened: Closed: Pending: 9 17 22

MFCU

Majority of Recoveries come from out of state Pharmaceutical companies. Vast majority of Providers in South Dakota are honest and ethical. These recoveries benefit South Dakota taxpayers.

MFCU Notable Case

Cary Feldman former optometrist in Rapid City Largest criminal health care provider fraud case ever prosecuted in South Dakota, in either State or Federal Court. $362,457.90 +__ $592.00 $363,049.90 $363,049.90 - $80,000.00 - $157,000.00 $126,049.90 Medicaid Restitution Medicare Restitution Total Restitution

Check Coin Collection Remaining Restitution to be paid

MFCU
Notable Case cont.
Feldman was convicted of: Grand Theft by Deception (Class 4 Felony) Making False Medicaid Claims (Class 5 Felony) Sentence: Grand Theft by Deception
10 years (the maximum)

Making False Medicaid Claims

5 years (the maximum)

Suspended Execution
15 years probation Pay all restitution Serve 6 months in county jail Optometry Board revoked his license Will be placed on OIG Exclusion List

MFCU
Notable Case cont.
Feldman case was investigated and prosecuted by MFCU, with assistance from:
South Dakota Department of Social Services Federal Department of Health and Human Services Office of Inspector General South Dakota Division of Criminal Investigation Spearfish Police Department Rapid City Police Department Pennington County Sheriffs Office Pennington County Office of States Attorney Minnehaha County Sheriffs Office South Dakota Office of United States Attorney South Dakota Board of Examiners in Optometry South Dakota Property Management (sale of coin collection)

Feldman case is a good example of State, Federal, and Local teamwork we leverage government resources to achieve results in a cost-effective manner.