Fraud Tip of the Day - May 1

Common Medicaid Scams

Be on the lookout 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

More Medicaid Scam Information