Position manages investigative assignments and/or projects by:
• Conducting complex criminal and civil
investigations involving Medicaid
provider fraud and patient abuse and neglect.
• Data analysis of Medicaid claims.
• Reviewing financial documents, including bank
statements, cancelled checks, corporate and
individual income tax returns, etc.
• Reviewing medical records and service notes of
Medicaid Recipients.
• Interviewing witnesses, including Medicaid
Recipients, current and former employees,
Medicaid Policy administrators, DHHS employees,
DSS employees, etc.
• Interviewing individuals suspected of committing
Medicaid provider fraud and patient abuse and
neglect.
• Preparing detailed reports from the results of
interviews conducted.
•Working with Federal, State and local law
enforcement agencies, including AUSAs.
• Testifying in State and/or Federal court.
• Understanding of the Rules of Evidence in criminal
investigations.
The Medicaid Investigations Division (MID) investigates and prosecutes health care fraud committed by Medicaid providers and the physical abuse of patients and embezzlement of patient funds in Medicaid-funded facilities. MID works closely with district attorneys’ offices, US Attorneys’ offices, federal, state and local agencies across the State. The damages in a Medicaid fraud case can range from a few thousand dollars to tens of millions of dollars. MID’s enforcement actions protect and recover taxpayer funds and help ensure access to needed medical services for Medicaid enrollees.