Medicaid Fraud Control Unit

The Medicaid Fraud Control Unit (MFCU), certified by the U.S. Department of Health and Human Services on March 1, 2000, investigates and prosecutes fraud and abuse in the administration of the Medicaid program. The unit also investigates allegations of abuse, neglect, and theft involving persons who reside in Medicaid-funded facilities or who receive Medicaid-covered services.

Investigations

The Investigations Unit (IU) investigates allegations of misconduct involving violations of District or federal criminal law, civil statutes, regulations, and employee standards of conduct.

Investigations Leadership

Kathryn Jones, Assistant Inspector General for Investigations

Inspections and Evaluations

The Inspections and Evaluations Unit (I&E) focuses its resources on conducting inspections and evaluations which call for corrective measures to improve operations, address deficiencies, and ensure compliance with District and federal laws, regulations, and policies. I&E projects provide District government managers with an independent source of facts and analysis about agency performance, program efficiency, the effectiveness of internal controls, and the potential for fraud, waste, abuse, and mismanagement.

Inspections and Evaluations Leadership

Risk Assessment and Future Planning

The Risk Assessment and Future Planning Unit (RAFP) evaluates risk related to corruption, mismanagement, waste, fraud, and abuse within the District. RAFP also assists the OIG in building the right capabilities to mine data for insights that will allow the agency to make proactive, knowledge-driven decisions. RAFP outputs are provided to the other operational units for action deemed appropriate.

Risk Assessment and Future Planning Leadership