Common Medicaid Rip-Offs and Tips to Prevent Fraud
Medicaid fraud can take many forms and knowledge is power when it comes to fraud prevention. Some of the most common rip-offs and fraud schemes include:
- Payments (in cash or in kind) in return for Medicaid numbers,
- Every patient in a group setting receiving the same type of service or equipment on the same day, and
- Services listed on your medical summary notice that you don't remember receiving or didn't need.
Common Fraud Schemes
- Billing for "phantom patients",
- Billing for medical goods or services that were not provided,
- Billing for more hours than there are in a day,
- Paying a "kickback" in exchange for a referral for medical goods or services,
- Concealing ownership in a related company,
- Using false credentials, and
- Double-billing for healthcare goods or services not provided.
Dos and Don'ts
- DO review your Medicaid bill carefully to ensure charges and dates of service are correct.
- DO ask for a copy of everything you sign.
- DO be suspicious of anyone offering free tests or screening in exchange for your Medicaid card number.
- DON'T give your Medicaid card or number to anyone except your doctor, clinic, hospital, or other healthcare provider.
- DON'T let anyone borrow or use your Medicaid card or number.
- DON'T ask your doctor or other healthcare provider for treatment or care that you do not need.
- DON'T sign your name to a blank form.
- DON'T share your medical records or other medical information with anyone except a doctor, clinic, hospital, or other healthcare provider.
If you know or suspect fraudulent activities report it!