Examples of Medicaid fraud include:

• Billing for medical services not actually performed.
  Examples:
  • Home health care visits that don't take place
  • Durable medical supplies that aren't delivered
  • Lab testing that wasn't ordered or performed
  • Dentist billings for treatments not rendered or fillings not completed.
  • Failing to provide adequate, necessary care recipients under the RiteCare Program (underutilization).
• Billing for a more expensive service than was actually rendered, billing for several services that should be combined intone billing, or billing twice for the same medical service.
  Examples:
• Billing single psychotherapy rates for group therapy
• Physician billing for therapies performed by paraprofessionals
• Dispensing generic drugs and billing for brand-name drugs or dispensing partially filled prescriptions without crediting Medicaid for the remainder.
• Kickbacks - giving or accepting something in return for medical services or referrals.
• Failing charge a co-payment, when co-pay is required, or charging a Medicaid recipient additional amounts for services that are fully covered under the Medicaid benefit.
• Providing or prescribing medically unnecessary services or drugs.
• Writing prescriptions in the name of a Medicaid patient for the treatment of a third party.
• Filing false cost reports.
• Billing for ambulance runs when medical service is provided, or transporting multiple passengers in ambulance and billing a run for each passenger.
  

What is Patient Abuse, Mistreatment or Neglect?