What is Medicaid fraud?
Medicaid fraud is billing for Medicaid services that you either didn’t provide or that you didn’t provide in compliance with all of the Medicaid rules and regulations. For example, billing for a new patient exam when you know perfectly well that the patient is actually an established patient as Medicaid fraud.
Billing for behavioral health services provided by a therapist you know is unqualified or under-qualified is Medicaid fraud. Every provider is responsible to make sure that his or her claims are accurate. And remember, you can’t shift the blame to your staff or your billing company.