State Health Care Fraud Control Unit

The Georgia State Health Care Fraud Control Unit was established in 1995 as required by the Omnibus Reconciliation Act of 1993, which requires the creation of a Medicaid Fraud Control Unit that is separate from the State's Medicaid agency. The Georgia State Health Care Fraud Control Unit (SHCFCU) was created pursuant to an Executive Order issued by Georgia Governor Zell Miller.

The SHCFCU is a jointly operated initiative of three state agencies:  The Georgia Bureau of Investigation (GBI), the Georgia Attorney General’s Office, and the Georgia Department of Audits and Accounts (DOAA).  As of January 4, 2004, there are 56 employees dedicated to this unit to work Medicaid fraud and patient abuse cases: GBI - 39, the Georgia Attorney General’s Office - 8, and the Department of Audits and Accounts – 9. The SHCFCU is a member of the National Association of Medicaid Fraud Control Units (NAMFCU). The SHCFCU is one of 48 Medicaid Fraud Control Units in the United States.

The State Health Care Fraud Control Unit effectively investigates and successfully prosecutes Medicaid funded doctors, dentists, hospitals, nursing homes, and other health care providers that treat Medicaid recipients. The SHCFCU investigates criminal abuse and neglect of residents in Nursing Homes and Personal Care Homes that receive Medicaid funding.

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