While exploring your options for Medicaid, you may also want to learn more about protecting yourself while using the state and federal program. You do not want to become a victim of Medicaid fraud or accidentally commit Medicaid fraud.
The Centers for Medicare and Medicaid Services breaks down different types of Medicaid fraud. Learn how to protect yourself while taking care of yourself.
Defining Medicaid fraud
Those who commit Medicaid fraud provide false information to have Medicaid cover the cost of medical services and care. A related fraud type is medical identity theft. Perpetrators use someone else’s medical information or card to receive medical care.
Different types of Medicaid fraud
Beneficiaries and providers may commit Medicaid fraud. Examples of intentional provider fraud include:
- Billing for unprovided items or services
- Billing for unnecessary medical items or services
- Treating and claiming reimbursement for a person other than the Medicaid beneficiary
- Writing needless prescriptions to sell medication or for personal use
- Filing erroneous reimbursement claims
Examples of intentional beneficiary fraud include:
- Giving another person your Medicaid ID so he or she can receive medical services
- Aiding your physician in filing erroneous claims for unnecessary medical tests
- Submitting false information to qualify for Medicaid
- Accepting referral payments from a physician
- Copying or changing a Medicaid ID for personal use or another’s personal use
Making yourself aware of the many forms of Medicaid fraud helps you avoid unintentionally committing fraud.
While preparing to apply for and use Medicaid, properly educate yourself on ways to protect your benefits. Do not let an unintentional mistake land you in legal boiling water.