Medicaid Fraud Schemes from the Office of Inspector General
The Department of Health & Human Services (HHS) established and
oversees multiple health care programs, including Medicare and Medicaid.
Within HHS is the Office of Inspector
General (OIG), which is tasked with making sure criminals and
fraudsters do not steal your Medicare and Medicaid funds. The OIG
considers the Senior Medicare Patrol (and you) as an
integral partner in the fight against fraudulent activity in our
health care system.
When a provider intentionally misrepresents the services
rendered and thereby increases its financial reimbursement from
Medicaid, fraud has occurred. Generally, Medicaid providers include
physicians, physician assistants, nurse practitioners, podiatrists,
dentists, hospitals, nursing homes, pharmacies, clinics, counselors,
personal care/homemaker chore companies and any other individual or
company that is paid by the Medicaid program. Medicaid fraud also
encompasses nursing home abuse and neglect cases. This includes
allegations of battery, sexual assault and failure to deliver services
or medications, When Senior Medicare Patrol projects learn of possible
Medicare fraud, they report it directly to the OIG.