State Medicaid Fraud Control Units

The Department of Health and Human Services Centers for Medicare and Medicaid Services awards funding under CFDA 93.775 to support State Medicaid Fraud Control Units that investigate and prosecute Medicaid provider fraud and patient abuse or neglect in health facilities, board and care facilities, and non-institutional settings, with the most recent grant awards issued October 1, 2025.

This is an active, stable program with consistent award volume. Over the past five years, the program has disbursed 53 awards annually. Since 2000, a total of 1,011 grants have been awarded, with $6.24 billion in combined federal dollars obligated. The program shows steady recent activity: grant awards were issued on October 1, 2025 (most recently) and October 1, 2024.

The funding architecture is predominantly Formula Grants (70 percent of awards, 710 total) with a smaller share of Project Grants (30 percent, 301 awards). All funding flows through the Centers for Medicare and Medicaid Services. Award sizes vary substantially by state population and Medicaid caseload: recent October 2025 awards ranged from $1.2 million (Wyoming) to $194.1 million (California), with mid-sized states typically receiving $8–40 million annually.

Eligibility is restricted to states, the District of Columbia, and U.S. territories. An established State Medicaid Fraud Control Unit must be a single identifiable entity of state government certified by the Secretary and annually re-certified by the Office of Inspector General as complying with Social Security Act requirements. American Indian tribes, Alaska Native entities, and Native American tribes are not eligible to apply.

Grant periods are one year in length. Funds are distributed quarterly (October 1, January 1, April 1, July 1) based on an approved annual budget. Applications for annual re-certification must be submitted 60 days prior to the end of each certification period. The Office of Inspector General performs periodic onsite reviews and annual re-certification review of each unit. Recipients must retain all records for three years per 2 CFR 200.334.

Recent awards (October 1, 2025) include $41.4 million to Ohio, $38.3 million to Virginia, $33.7 million to Pennsylvania, and $31.5 million to Illinois. The program does not operate on a competitive solicitation cycle; eligible states receive formula-based awards on a fixed annual schedule.