Medicaid fraud can take many forms. You can avoid being taken advantage of by unscrupulous individuals by watching for the following:

• Payments (in cash or in kind) in return for Medicaid numbers,
• Every patient in a group setting receiving the same type of service on the same day,
• Every patient in a group setting receiving the same type of medical equipment, and
• Services listed on your medical summary notice that you don’t remember receiving or didn’t need.

Medicaid Fraud Schemes

• Billing for “phantom patients” who did not really receive services
• Billing for medical services or goods that were not provided
• Billing for old items as if they were new
• Billing for more hours than there are in a day
• Billing for tests that the patient did not need
• Paying a “kickback” in exchange for a referral for medical services or goods
• Charging Medicaid for personal expenses that have nothing to do with caring for a Medicaid client
• Overcharging for health care services or goods that were provided
• Concealing ownership in a related company
• Using false credentials
• Double-billing for health care services or goods that were provided

If you suspect any of these schemes or other possible fraud, report it. Information on how you can report fraud and who you should contact can be found in the How To Report Suspected Fraud link located on the left navigation column.

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Page Last Modified: 12/14/2005 11:14:00 AM
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