Medicaid Fraud - Reporting
You are encouraged to report matters
involving Medicaid fraud, waste and abuse. To assist you in
combating fraud you are being provided with the following guidelines.
Before you get in touch with your state Medicaid contact or call
the National Fraud Hotline, please be ready to provide as much
information as possible, including:
- The name of the Medicaid client
- The client's Medicaid card number
- The name of the doctor, hospital, or
other health care provider
- The date of service
- The amount of money that Medicaid
approved and/or paid
- A description of the acts that you
suspect involves fraud or abuse relating to your allegation.
(Source: hhs.gov)
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Medicaid Fraud
Reporting - Who to Contact
Contact Your State Directly - Medicaid
is a joint Federal and State-funded program. Although the Federal
Government requires that certain persons are eligible for Medicaid
benefits and sets standards for quality of care, the States carry out
most of the day-to-day business of Medicaid.
If you suspect that fraud is
being committed against Medicaid, your first contact should be
the Program Integrity contact in the agency that oversees your State's
Medicaid program, which is usually called the State Medicaid Agency. Our
list of State Contacts (see link below) provides the name of the Program
Integrity contact that you should use to report suspected fraud, whether
it involves a person, a company, or an agency.
Call the OIG National Fraud Hotline - A second way to report suspected
fraud in Medicaid is to call the Office of Inspector General's (OIG)
National Fraud Hotline (see link below). This hotline handles calls
about both Medicaid and Medicare, but it is not as direct as calling
your State contact.
If you choose to use the Hot Line as a means of reporting fraud, you are
still asked to use the guidelines listed above before you make your
call. Dial 1-800-HHS-TIPS - (1-800-447-8477) |
