Definition
Programs that provide a hotline, website or other mechanisms that Medicaid recipients and the public at large can use to report recipients or health care providers that make false statements or representations which result in an unauthorized payment by the Medicaid program to themselves or another. Examples of fraud include incorrect reporting of diagnoses or procedures to maximize payments; billing for services, medical supplies or equipment not furnished; misrepresentation of the dates and descriptions of services furnished, the identity of the recipient or the individual furnishing services; and billing for noncovered or nonchargeable services as covered items.
URL Name
FN-1700-9500-500
Third Level Code
FN-1700
Taxonomy Code
FN-1700.9500-500
Parent Code
FN-1700.9500
Family Code
F
Second Level Code
FN
Fifth Level Code
FN-1700-9500-500
Fourth Level Code
FN-1700-9500
Use References
BadgerCare Fraud Reporting, Medi-Cal Fraud Reporting, Title 19 Fraud Reporting, Title XIX Fraud Reporting
Publication Status
Online