What are examples of Medicaid fraud?

Drug Diversion prescriptions, or altering prescriptions, to obtain drugs for personal use or to sell them. Altering a doctor’s prescription, going to multiple doctors to get more of the same drug, or selling your drugs to others.

Can I report Medicaid fraud anonymously?

If you know or believe that Medicaid fraud or abuse is happening, please report it so it can be properly investigated. If you want to make a report, you can remain anonymous, but sometimes we may need to contact you in order to conduct an effective investigation.

How do I report medical fraud in NY?

Phone

1. 1-800-663-6114 – Complaints/Inquiries.
2. 1-518-402-0836 – Main Number.

Is Medicaid fraud a felony in New York?

New York Medicaid Fraud is illegal and prosecuted at both the state and federal level. Fifth degree health care fraud (no profit – a class A misdemeanor) Fourth degree ($3000 in one year – class E felony)

Who commits the most Medicaid fraud?

Florida has the high honor of being the state where most of the fraud was allegedly committed, with over $200 million of fraud allegedly carried out there. Individuals in California, Texas, and Michigan are charged with committing more than $100 million worth of fraud in each state.

What happens if you lie to Medicaid?

Consequences for lying on a Medicaid application can be as serious as facing hefty fines to repay the money spent on health care services or face criminal prosecution and spend up to five years in prison.

How do I report someone for fraud?

Contact the Federal Trade Commission at 1-877-FTC-HELP, 1-877-ID-THEFT, or online at www.ftc.gov. Contact the National Center for Disaster Fraud at (866) 720-5721, by fax at (225) 334-4707 or submit a complaint through the NCDF Web Complaint Form.

What happens when you report Medicare fraud?

If your suspicion is confirmed and leads directly to the recovery of Medicare money, you may get up to $1,000 as a reward. For more information on how to report fraud, see Center for Medicare & Medicaid Services’ guidance reporting fraud.

How do I report fraud in NY?

How to Report Fraud in New York

1. New York Office of the Attorney General. Attorney General: Eric T.
2. Fraud Hotlines. General Helpline: 1-800-771-7755.
3. Report Welfare Fraud in New York.
4. FBI Field Offices, Mortgage Fraud.
5. New York State Consumer Protection Board.
6. HUD Field Offices.
7. HUD Regional Office.
8. New York Banking Department.

Is there a reward for reporting Medicare fraud?

What are the rewards for reporting Medicare fraud? Individuals who bring a case under the FCA are generally entitled to between 15 and 25% of whatever funds the government is able to recover.

Does Medicaid investigate?

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud as well as patient abuse or neglect in health care facilities and board and care facilities. MFCUs operate in 49 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.

How does Medicaid verify your income?

Documentation of income might include any of the following: Most current pay stubs, award letter for Social Security, SSI, Railroad Retirement, or VA, pension statement, alimony checks, dividend checks, a written statement from one’s employer or from a family member who is providing support, an income tax return, or a …

What constitutes Medicaid fraud?

Medicaid fraud is an intentional deception or misrepresentation made by an individual with the knowledge that the deception or misrepresentation may result unauthorized benefit to an individual or some other person. Medicaid fraud includes any actions or inactions that constitute fraud under federal or state law.

What is the punishment for Medicaid fraud?

Medicaid fraud can be charged as a civil violation or as a crime, with potential penalties including recoupments, fines, jail time, program exclusion, and more.

Do you qualify for Medicaid in New York?

To qualify for Medicaid, federal law states that you must be a United States citizen or legal immigrant with at least five years of residency. New York’s Medicaid program also requires you to be a current resident of New York.

What is the Medicaid fraud control unit?

Medicaid Fraud Control Unit. The Attorney General’s Medicaid Fraud Control Unit (MFCU) investigates and prosecutes fraud involving providers that intentionally defraud the state’s Medicaid program through fraudulent billing practices. Medicaid fraud essentially steals from Florida’s taxpayers.

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