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How to Identify Recipient Fraud

Fraud is a deliberate deception or misrepresentation that someone makes in order to receive benefits he or she does not deserve.

Most people are honest and hardworking. A few individuals try to game the system to receive money or benefits they don't deserve. They are making a mistake – it is a crime to commit insurance fraud, and people can lose their benefits for it, and be prosecuted.

Examples of fraudulent recipient activities include:

  • Loaning a Medicaid Identification or other insurance card to another person
  • Using someone else's Medicaid Identification or other insurance card
  • Forging or altering a prescription
  • Doctor shopping in order to obtain multiple prescriptions
  • Using multiple Medicaid Identification cards
  • Intentionally receiving unneeded services or supplies
  • Accepting cash or other bribes for receiving services
  • Re-selling items provided by the Medicaid program
  • Deliberately giving incorrect information to receive benefits
 

 

Suspect Waste, Fraud or Abuse?

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