National Association of Medicaid Fraud Control Units

National Association of Medicaid Fraud Control Units



Founded in 1978, the National Association of Medicaid Fraud Control Units (NAMFCU) has played a pivotal role in providing the MFCUs with a national presence. This unique Association has enabled the Units to deter some of the largest and most insidious health care provider frauds, recover program dollars, punish corrupt practitioners, and prosecute those who abuse or neglect nursing home residents. Although membership is voluntary, all 53 federally certified MFCUs are members of the Association. Membership is limited to federally certified MFCUs and each Unit is represented by their Director. The officers of the Association, the President and Vice- President are elected annually by the Directors. The President is the principal spokesperson for the Association, presides at all Association meetings, and appoints the Chair and members of the various Committees and Working Groups. There are six regions of NAMFCU and each region elects a representative annually. These six regional representatives, the President, Vice-President, the Director of the New York MFCU and all past Presidents of the Association are members of the NAMFCU Executive Committee. This Committee manages the Association.

NAMFCU is housed at the National Association of Attorneys General in Washington, D.C.

History of NAMFCU

One year after the signing of P.L. 95-142, the Medicare-Medicaid Anti-Fraud and Abuse Amendments, by President Jimmy Carter on October 25, 1977, 19 MFCU Directors met formally for the first time in Mt. Laurel, New Jersey at the inaugural National Training Conference for Medicaid Fraud Control. These Directors met with key staff of the then-U.S. Department of Health, Education and Welfare (HEW) to discuss regulations, criteria for Unit certification and recertification and other matters of mutual concern. It was at this first meeting, due to a difference in opinion with HEW staff regarding the reporting requirements of the Units and the need for investigative confidentiality, that the Unit Directors recognized the need to form a national association.

Formal organization of the National Association of Medicaid Fraud Control Units took place two months later, on December 12, 1978 at the National Conference on Fraud, Abuse and Error in Washington, D.C. The Unit Directors from the 20 then-certified states met to elect a President and to form an Executive Committee that would ensure that all states had equal representation. Charles (Joe) Hynes, New York State Deputy Attorney General and Special Prosecutor for Nursing Homes, Health and Social Services was elected the first NAMFCU President.