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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:

Common Rip-offs

  • 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!                                        whistle