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Some Medicaid recipients engage in fraudulent behavior and abuse their privileges. The Office of the Medicaid Inspector General reviews recipient utilization and investigates other charges of fraudulent behavior in order to take appropriate actions. Some types of recipient fraud, such as forging prescriptions, are subject to criminal prosecution and will be referred to the appropriate authorities.
Examples of Recipient Fraud
Medicaid recipient fraud can take several forms, and the OMIG welcomes the cooperation of diligent honest providers, Medicaid recipients, and individual citizens to uncover this type of activity. Recipient fraud includes: - Loaning his/her Medicaid Identification card to another person;
- Forging or altering a prescription or fiscal order;
- Using multiple Medicaid ID cards;
- Intentionally receiving duplicative, excessive, contraindicated, or conflicting health care services or supplies; and
- Re-selling items provided by the Medicaid program.
How to Report Recipient Fraud
If you suspect that a recipient has engaged in any of the activities listed above or any other questionable activity: |
