A Guide to Understand Medicaid Fraud & Scams

A Guide to Understand Medicaid Fraud & Scams A Review From Health 2.0 Conference

● What is Medicaid?

Table of Contents

● What is Medicaid Fraud? ● Most Common Types of Medicaid Scams ● Red Flags Of Medicaid Scams

What is Medicaid?

● Medicaid is a government-funded assistance programme.

It mainly benefits low-income people of all ages.

Mostly, patients do not have to worry about any of the expenditures associated with reimbursed medical expenses.

Occasionally, a minor co-payment is required.

Medicaid is a joint federal-state initiative.

It differs from one state to the next. It is generally administered by the state governments complying to the federal regulations.

What is Medicaid Fraud?

Eminent international health awareness conferences like Health 2.0 Conference talk about Medicaid Fraud. Here are some of the stated definitions: The intentional provision of false information to get Medicaid to pay for medical care or services is known as Medicaid fraud.

One sort of fraud is medical identity theft.

It entails obtaining health care goods, services, or finances using another person's medical card or information.

The intentional provision of false information to get Medicaid to pay for medical care or services is known as Medicaid fraud.

One sort of fraud is medical identity theft. It entails obtaining health care goods, services, or finances using another person's medical card or information.

Most Common Types of Medicaid Scams

Unnecessary Services: Medicaid covers only medically essential procedures or fees. So, consider yourself trapped in a scam if your doctor suggests an approach that is minimal or not related to your condition.

Failure to Properly Charge Medicaid Patients for Prescriptions: Global wellness conferences like Health 2.0 Conference suggest that if a pharmacist charges extra from Medicaid patients, this can be termed a violation or a scam.

Program rule violation can lead to a successful False Claims Act action against the pharmacist.

Examinations Performed by Nurses & Charged As Per the Doctor’s Rate: Allowing nurses or office staff to handle essential outpatient treatments while paying the government for the cost of the doctor's time to perform the work is an expanding unlawful trend.

Upcoding: It entails invoicing for services never supplied or billing for the patient's benefit when a similar but less expensive service was rendered.

Red Flags of Medicaid Scams

● Offer "free" consultations in exchange for your Medicaid card number.

Attempt to persuade you to purchase more expensive services.

Charge Medicare for services or equipment you didn't get or aren't entitled to.

Use telemarketing or door-to-door sales as marketing strategies.

Firm claim to be from the government or perform employ fear tactics.

This presentation was prepared by

Thank You!

Bhawna Lawera, Manager, Health 2.0 Conference https://www.health2conf.com/