Innovative Care upholds the highest standards of compliance.
Medicaid Fraud affects us all! Have you witnessed fraud, incompliance or fraud? Complete our form below or call our office number 585-235-0560 to report incidents!
Examples of recipient fraud include:
Lending or sharing a Medicaid Identification card
Forging or altering a prescription or fiscal order
Using multiple Medicaid ID cards
Re-selling items provided by the Medicaid program
Selling or trading the card or number for money, gifts or non-Medicaid services
Signing timesheets for hours or services that were not rendered
OMIG reviews provider billing and other activities and investigates charges of fraudulent behavior.
Examples of provider fraud include:
Billing for Medicaid services that were not provided
Billing for unnecessary services
Selling prescriptions
Intentionally billing for a more expensive treatment than was provided
Giving money or gifts to patients in return for agreeing to get medical care
Accepting kickbacks for patient referrals
Examples of aide fraud include:
Billing for Medicaid services that were not provided
Example: Arriving at a client’s home and using EVV to clock in, then leaving and returning only to clock out.
Submitting fraudulent signatures on timesheets
Double Billing: billing when more than one service is being provided. Billing with more than one client at a time. Example: Billing while patient receives dialysis. Billing while patient is admitted to hospital. Performing care for more than one person and billing for that care (working with two people in a home at the same time – Medicaid is a 1x1 service).
Giving money or gifts to patients in return for agreeing to get medical care
Accepting kickbacks for patient referrals
Sleeping during your shift.
Running personal errands while you are working. Example: Picking up paycheck during your shift. Doing personal grocery shopping during shift.
Completing items not on the care plan.
Pre-Signing timesheets or having the client sign blank/incomplete time records.