Return to the main page | Previous document | Next document


Program C: Criminal Law and Medicaid Fraud

Program Authorization: La. Constitution, Article IV, Sec. 8; R.S. 36:701(D); 36:704(D); 42 CFR 1002.301 et seq.; P.L. 98-473, 42 USC 3711 (Justice Assistance Act of 1984); R.S. 49:257 (B); R.S. 13:4448; La. Code of Criminal Procedure, Article 67; La. Code of Civil Procedure, Article 1880; R.S. 49:251-253; R.S. 15:1311(B); 42:66(G); La. Code of Criminal Procedure, Article 261-280; R.S. 36:701(E)

PROGRAM DESCRIPTION

The mission of the Criminal Law and Medicaid Fraud Program is to seek justice on behalf of the citizens of the state of Louisiana by the execution of superior, professional, and effective investigation and prosecution of all matters referred to the Department of Justice.

The goals of the Criminal Law and Medicaid Fraud Program are:

1. Provide superior legal and professional services to the State of Louisiana.

2. Develop a working environment that encourages competent individuals to seek career employment in the Criminal Law and Medicaid Fraud Program of the Department of Justice.

3. Improve cooperative working relationships with federal, state, and local agencies and private sector organizations.

The Criminal Law and Medicaid Fraud Program includes two activities (organizationally expressed as divisions): Criminal Division and Criminal Investigations Division. The functions of both divisions are supervised by the deputy attorney general, program manager, who is responsible for monitoring the activities of all staff personnel, including the division directors, as well as for the administration and implementation of policy.

The Criminal Division activity of the Department of Justice is divided into six sections: Administrative; Secretarial Support; Prosecution and Technical Assistance; Violent Crime/Drug Offender Prosecution Program; Medicaid Fraud Control Unit; and Special Services (Extraditions, Appeals, Habeas Corpus and Opinions).

The Administrative Section supervises, controls and coordinates all personnel and functions of the Criminal Division.

The Prosecution and Technical Assistance Section prosecutes alleged violations of the criminal laws of the state by conducting or assisting in criminal prosecutions pursuant to the recusal or request of district attorneys. This section also serves as: 1) advisor to the district attorneys, law enforcement and the legislature; 2) a training agency for law enforcement; and 3) as liaison between various levels of law enforcement within the state.

The Violent Crime/Drug Offender Prosecution Program, which operates pursuant to federal grant funding with state matching funds, focuses on the prosecution of violent, career criminals, and serious narcotics offenders.

The Medicaid Fraud Control Unit (MFCU) investigates and prosecutes individuals and entities defrauding the Medicaid Program or abusing residents in health care facilities. It also initiates recovery of identified overpayments.

The Special Services Section provides legal services to the state in the areas of: 1) extradition; 2) appeals and habeas corpus proceeding; 3) as amicus curiae in matters pending before the U.S. Supreme Court; and through preparation of attorney general opinions concerning matters of criminal law.

The Criminal Investigation Division activity is divided into four sections: Administrative Section, Trial Section, Special Investigations Section, and General Investigations and Government Support Section.

The Administrative Section supervises, controls, and coordinates all personnel and functions of the Investigative Division.

The Trial Section provides follow-up investigation services for the trial attorneys of the criminal division. The investigations are those things deemed necessary by the assistant attorneys generals which were not done by the primary investigative agency. These services include locating witnesses who have moved since the offense occurred, running record checks on potential witness, providing transportation for victims and witnesses who have none, providing security for victims, witnesses and assistant attorneys general, procurement of evidence, and witness management during trial. This unit acts in the same manner as district attorneys' investigators.

The Special Investigations Section provides investigative services in those cases referred to the Department of Justice involving white collar crimes or public corruption. Due to the fact that many district attorneys lack personnel with the necessary expertise or wish to avoid becoming embroiled in local politics, this type of crime is an ever-increasing part of our caseload. Appropriately, this section is staffed with accountants and certified fraud examiners as well as first line investigators.

The General Investigations and Government Support Section provides investigative services in all matters not covered by the two specialized units referred to above. Additionally, this section responds to the numerous requests for investigative assistance from any governmental agency, local, state, or federal.

TRENDS IN CRIMINAL LAW AND MEDICAID FRAUD PROGRAM ACTIVITIES

 

1992-93

1993-94

1994-95

1995-96

1996-97

Number of new felony prosecutions referred to program

Not available 1

Not available 1

Not available 1

Not available 1

266 2

Total number of prosecutions handled

Not available 1

Not available 1

Not available 1

Not available 1

463 2

Number of parishes in which prosecutions were handled

Not available 1

Not available 1

Not available 1

Not available 1

45

Number of federal habeas cases handled

Not available 1

Not available 1

Not available 1

Not available 1

10

Number of extradition cases processed

334

302

291

440

288

Number of Medicaid Fraud Control Unit (MFCU) investigations pending

141 3

161 3

245 3

277 3

177

Number of MFCU prosecutions initiated

40 3

44 3

65 3

59 3

56

Dollar amount collected from all sources by MFCU

$686,116 3

$2,963,914 3

$1,145,829 3

$625,497 3

$3,387,880 4

Number of criminal investigations initiated

542

528

516

549

190

Number of criminal investigations closed

332

490

501

553

129

Number of citizen requests handled or resolved by Investigations Division

407

405

361

436

392

1 New indicator for which information has not been reported in prior years.

2 Reflects an election year for district Attorneys. Traditionally, the number of cases referred for prosecution increases during the election year and year following election.

3 Indicator was reported on a calendar year (CY) basis in past. Indicator values for FY 1992-93 are values previously reported for CY 1993; indicator values for FY 1993-94 are values previously reported for CY 1994; indicator values for FY 1994-95 are values previously reported for CY 1995; indicator values for FY 1995-96 are values previously reported for CY 1996.

4 Approximately $2 million of this total resulted from two national settlements.

OBJECTIVES AND PERFORMANCE INDICATORS

1. In FY 1998-99, the Criminal Law and Medicaid Fraud Program will improve the quality of criminal prosecutions by expanding professional training for Criminal Division attorneys by 5%.

1 New indicator for which some values are not available.

2. In FY 1998-99, the Criminal Law and Medicaid Fraud Program will improve the quality of investigative efforts by expanding enhanced investigative training by 5%.

1 New indicator for which FY 1996-97 value was not available.

2 Decrease reflects the inclusion of 900+ hours of basic training for three new investigators in the overall total training hours for FY 1996-97 and lack of basic training for any new investigators in FY 1997-98 training hours.

3 This figure includes 900+ hours of basic training for three new investigators.

4 This figure does not include any basic training for any new investigators hired.

3. In FY 1998-99, the Criminal Law and Medicaid Fraud Program will improve the quality of cases handled by the program by coordinating efforts between investigators and prosecutors within a required maximum of 14 days of receipt of a case in the Criminal Division and making initial contact with victim(s) and/or witness(es) within a required maximum of 14 days of initial consultation between assigned attorney and investigator.

1 New indicator for which FY 1996-97 figures is not available.

4. In FY 1998-99, the Criminal Law and Medicaid Fraud Program will reduce processing time for attorney general opinions handled by the program by 4%.

1 New indicator.

2 New indicator. In prior years, an input indicator for all opinion requests received (regardless of division to which they were assigned) was reported. Beginning in FY 1997-98, opinion requests will be recorded by division to which they are assigned. Insufficient prior year data are available to allow accurate forecasts for FY 1997-98 or FY 1998-99.

3 Preliminary figures, since 1997 opinions will continue to be released through March 1998, which will alter those numbers reported in indicators for requests withdrawn and opinions released.

4 It is not possible, at this time, to accurately forecast the number or percentage of these assigned cases that will be withdrawn or released.

Explanatory Note: Currently, computer research of Louisiana attorney general opinions is available through WESTLAW from January 1977 to present and through LEXIS from September 1974 to present. The Louisiana Senate also has attorney general opinions on its computer system from 1990 to present.

5. In FY 1998-99, the Criminal Law and Medicaid Fraud Program will limit time for processing extradition requests to five working days.

1 New indicator for which FY 1996-97 figure is not available.

2 The actual number of extraditions processed ranged from 334 in FY 1992-93; 302 in FY 1993-94; 291 in FY 1994-95; 440 in FY 1995-96; to 228 in FY 1996-97. FY 1997-98 estimates and FY 1998-99 projections are based on an average of the actual numbers processed during the last five fiscal years.

6. In FY 1998-99, the Criminal Law and Medicaid Fraud Program will enhance efficiency by increasing utilization of electronic/computer resources by 10%.

1 New indicator for which FY 1996-97 figure is not available.

7. In FY 1998-98, the Criminal Law and Medicaid Fraud Program will increase by 25% the number of training programs provided by the Medicaid Fraud Control Unit (MFCU) for state agency personnel and health care providers in the area of prevention and detection of Medicaid fraud and abuse of the infirm.

1 New indicator for which FY 1996-97 figure is not available.

8. In FY 1998-99, the Criminal Law and Medicaid Fraud Program, through the Medicaid Fraud Control Unit, will increase initiation of proactive projects to detect abuse of the infirm and Medicaid fraud.

1 New indicator for which FY 1996-97 figure is not available.

RESOURCE ALLOCATION FOR THE PROGRAM

SOURCE OF FUNDING

This program is funded with state general fund, interagency transfers, statutory dedications and federal funds. Interagency transfers are derived from various state agencies for investigative and legal services. Fees and self-generated revenues were previously budgeted from revenue received from non budget units to provide legal services. Statutory dedications, from the Department of Justice, Claims Recovery Fund, were derived from settlements or debts owed the state and collected by this department. (Per R.S.39:32B.(8), see table below for a listing of expenditures out of each statutory dedicated fund.) Federal funds are derived from the Department of Health and Human Services Medicaid Fraud Unit and the United States Department of Justice for drug prosecution.

ANALYSIS OF RECOMMENDATION

GENERAL FUND

TOTAL

T.O.

 

DESCRIPTION

 

 

 

 

 

$1,240,303

$2,781,409

73

 

ACT 18 FISCAL YEAR 1997-1998

 

 

 

 

 

 

 

 

 

BA-7 TRANSACTIONS:

$1,559,973

$1,559,973

0

 

Enactment of Act 593 of 1997 which provides that when the elimination of the claims recovery fund is reflected in the Revenue Estimating Conference, that the means of financing for the Claims Recovery Fund shall be reduced to the amount reflected in the REC forecast and that State General Fund shall be increased by the difference between this amount and the amount appropriated from the Claims Recovery Fund

 

 

 

 

 

$2,800,276

$4,341,382

73

 

EXISTING OPERATING BUDGET - December 10, 1997

 

 

 

 

 

($98,616)

($181,920)

0

 

Equipment/Major Repairs Adjustment(s) (Nonrecurring: -$98,616)

($12,619)

($12,619)

0

 

Retirement Rate Adjustment(s)

$65,000

$65,000

0

 

Implementation of agency's unclassified attorneys pay schedule

 

 

 

 

 

$2,754,041

$4,211,843

73

 

TOTAL RECOMMENDED

 

 

 

 

 

($46,235)

($129,539)

0

 

DIFFERENCE (TOTAL RECOMMENDED AND EXISTING OPERATING BUDGET)

The total means of financing for this program is recommended at 97.0% of the existing operating budget. It represents 93.7% of the total request ($4,494,147) for this program. The net decrease is primarily due to the removal of funding for nonrecurring acquisitions along with increased funding to provide for implementation of the agency's unclassified attorneys pay schedule.

PROFESSIONAL SERVICES

$18,388

 

Legal services costs for expert witnesses, taking depositions and other related legal expenses

 

 

 

$18,388

 

TOTAL PROFESSIONAL SERVICES

OTHER CHARGES

$418,874

 

Funding for taking depositions, court costs and travel of special witnesses

 

 

 

$418,874

 

TOTAL OTHER CHARGES

 

 

 

 

 

Interagency Transfers:

$14,690

 

Funding to the Department of Public Safety and Corrections for gasoline purchases

 

 

 

$14,690

 

TOTAL INTERAGENCY TRANSFERS

 

 

 

ACQUISITIONS AND MAJOR REPAIRS

This Program Does Not Have Funding for Acquisitions and Major Repairs for Fiscal Year 1998-1999.


Return to the main page | Previous document | Next document