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Laws and Regulations

The Wisconsin Medicaid Fraud Control and Elder Abuse Unit (MFCEAU) investigates and prosecutes Medicaid provider fraud as well as patient abuse or neglect in health care facilities and board and care facilities. The MFCEAU has original criminal jurisdiction for the investigation and prosecution of Medicaid fraud crimes and “laws affecting the health, safety, and welfare of public assistance program recipients.” Wis. Stat. § 49.846(2).

The MFCEAU relies upon many different laws in its criminal and civil prosecutions involving both Medicaid fraud and elder abuse. The laws referenced below are representative of the ones most commonly charged against defendants. However, the charts are not intended to be all-inclusive. The crimes charged depend upon the specific circumstances of each particular case, and each case is different. The MFCEAU has also issued charges of: Theft, Forgery, Identity Theft, Invasion of Privacy, Representations Depicting Nudity, Income Tax Fraud, Racketeering, etc.

Criminal Statutes

  • Medical Assistance Fraud

         Wis. Stat. § 946.91(2)(a)

  • Intentionally make or caused to be made a false statement or representation of a material fact in an application for a Medical Assistance benefit or payment
  • Public Assistance Fraud

         Wis. Stat. § 946.93 

  • Intentionally makes or causes to be made any false statement or representation of material fact in any application for or receipt of public assistance
  • Abuse of Individuals at Risk

         Wis. Stat. § 940.285

  • Abuse & Neglect of Patients and Residents

         Wis. Stat. § 940.295

Civil Medicaid Fraud Statutes

  • False Claims Act

         Wis. Stat. § 49.485


  • Medical Assistance Fraud

         Wis. Stat. § 49.49(4m)