The National Consumer Protection Technical Resource Center: The Center of Service & Information for SMPs

Health Care Fraud

From the Office of Inspector General (OIG), U.S. Department of Health & Human Services

Abuse and Neglect Fraud

Elderly abuse is very common and underreported. Whether it be from a visiting caregiver or a caregiver in an institutional setting, the beneficiary has the right to quality care without coercion, intimidation or physical abuse.

How the Scam Works

  • The beneficiary notices that quite often the caregiver doesn’t show up or shows up only briefly and doesn’t perform the required work.
  • The beneficiary is threatened by the caregiver that he better do as the caregiver says or the caregiver will leave and he will have nobody to care for him at all.
  • Coercing or threatening beneficiaries to surrender their medications for the diversion activities described above.
  • Coerced into receiving therapy when it is not needed or refused.

How to Fight Back

  • It is never acceptable for a caregiver of any type to physically strike or harm you or a loved one in any way. Nor is there any acceptable justification for a caregiver intentionally failing to provide you with the medicine or services she is required to provide as part of the medical treatment.
  • If a caregiver ever abuses or neglects you or someone you know, contact his supervisor immediately. If doing so does not resolve the problem, or if you do not feel comfortable talking to that person, then call the State’s Medicaid Fraud Control Unit, which investigates allegations of abuse and neglect of Medicaid patients.

Report Suspected Fraud

To report suspected fraud, click here.