Term Medicaid Fraud Reporting
Code FN-1700.9500-500
Definition Programs that provide a hotline 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.
Created 10/25/99
Changed 10/27/15
Use References BadgerCare Fraud Reporting
Medi-Cal Fraud Reporting
Title 19 Fraud Reporting
Title XIX Fraud Reporting
See Also References Medicaid (NL-5000.5000)
Medicaid Information/Counseling (LH-3500.4900)
Medicare Fraud Reporting (FN-1700.3350-550)
External Classification Terms Citizen Crime Reporting (NPC I02.02)
Law Enforcement (UW 6.1.02.01)
Law Enforcement (NTE I60)
Legal, Consumer and Public Safety Services (AIRS LE-450)
Legal/Public Safety (CAN LP-450)
Related Concepts Financial Services/Benefits
Named Programs
U.S. Services/Targets
Facet Named Programs
Comments
Bibliographic References

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