What does the Office of Medicaid fraud and abuse do?
Office of Medicaid Fraud and Abuse The Office of the Attorney General believes that every patient in a nursing home, Medicaid facility, or personal care home deserves to be treated with dignity and respect and should be free from patient abuse, neglect, or exploitation. Instances of abuse are investigated, and when appropriate, prosecuted.
How do I report fraud or scam in Kentucky?
To report fraud or a scam in the state of Kentucky, start with the Attorney General, Better Business Bureau or contact the local municipal, state or Federal regulators most likely to have answers to your questions.
What are some examples of Medicare fraud and abuse?
Medicare fraud and abuse can happen anywhere, and usually results in higher health care costs and taxes for everyone. Some examples include: A provider that bills Medicare for services or supplies they never gave you, like charging you for a visit you never had, or a back brace you never got.
What do I do if my Medicare card is stolen?
If you suspect that Medicare is being charged for an item or service you didn't get, or your Medicare card or number is stolen, use the contact information below to report suspected fraud or abuse. Provider fraud or abuse in Original Medicare (including a fraudulent claim, or a claim from a provider you didn’t get care from)
How do you address Medicare fraud?
If you suspect Medicare fraud, do any of these: Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. Call the fraud hotline of the Department of Health and Human Services Office of the Inspector General at 1-800-HHS-TIPS (1-800-447-8477). TTY users can call 1-800-377-4950.
What are factors for Medicare fraud?
Looking out for Medicare fraud Pressure you into buying higher-priced services. Charge Medicare for services or equipment you have not received or aren't entitled to. Charge you for copayments on services that are supposed to be covered 100% by Medicare.
What are the consequences of Medicare fraud?
It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent. Filing false claims may result in fines of up to three times the programs' loss plus $11,000 per claim filed.
What is considered Medicare abuse?
What Is Medicare Abuse? Abuse describes practices that may directly or indirectly result in unnecessary costs to the Medicare Program. Abuse includes any practice that does not provide patients with medically necessary services or meet professionally recognized standards of care.
What is a red flag banking?
Red flags are suspicious patterns or practices, or specific activities that indicate the possibility of identity theft. For example, if a customer has to provide some form of identification to open an account with your company, an ID that doesn't look genuine is a red flag for your business.
What is the Red Flags Rule healthcare?
The Red Flags Rule requires that organizations have “reasonable policies and procedures in place” to identify, detect and respond to identity theft “red flags.” The definition of “reasonable” will depend on your practice's specific circumstances or specific experience with medical identity theft as well as the degree ...
What agency fights Medicare fraud?
the Office of the Inspector GeneralContacting the Office of the Inspector General. Visit tips.oig.hhs.gov or call 1-800-HHS-TIPS (1-800-447-8477). TTY users can call 1-800-377-4950.
Which is the most common form of health care fraud and abuse?
Fraudulent provider billing, duplicate billing, and billing for services not medically needed accounted for 46 percent of provider fraud cases in 2016. Billing for services not performed is the most common provider fraud activity and defrauds millions from public and commercial insurers alike.
What are the three examples Medicare uses to describe abuse?
Common types of abuse include: Billing for unnecessary services (services that are not medically necessary) Overcharging for services or supplies. Misusing billing codes to increase reimbursement.
How to report Medicaid fraud in Kentucky?
Kentuckians who suspect an adult has suffered abuse, neglect, or exploitation, or believe an attempt has been made to commit fraud against the Kentucky Medicaid Program, should report this information to the Attorney General's Office by calling our Elder Abuse and Medicaid Fraud Hotline at 1-877-228-7384 or by completing our online Medicaid Fraud and Abuse Complaint Form at ag.ky .gov/MedicaidFraud. Complaints may be made anonymously.
What is the Office of Medicaid Fraud and Abuse Control?
Office of Medicaid Fraud and Abuse Control. The Office of the Attorney General believes that every patient in a nursing home, Medicaid facility, or personal care home deserves to be treated with dignity and respect and should be free from patient abuse, neglect, or exploitation. Instances of abuse are investigated, and when appropriate, prosecuted.
Commonwealth of Kentucky
Office of the Attorney General Attorney General: Jack Conway http://ag.ky.gov/
Savings & Loan Association or Savings Bank
Office of Thrift Supervision Consumer Complaints and Inquiries Email: [email protected]
How to report Medicaid fraud?
To make a report, please call the Welfare and Medicaid Fraud Hotline at 1-800-372-2970.
What is the Office of Medicaid Fraud and Abuse?
Our Office of Medicaid Fraud and Abuse also prosecutes criminals who harm our vulnerable adults, including the elderly as well as adults with physical or mental disabilities. In addition to investigations and prosecutions, the Office of Medicaid Fraud and Abuse has provided education and outreach to communities to help empower individuals to identify and prevent abuse and neglect of Kentucky's seniors.
Who investigates Medicaid fraud?
The Office of Medicaid Fraud & Abuse investigates provider fraud. Providers include medical doctors, dentists, hospitals, nursing homes, pharmacies, durable medical equipment sellers, ambulance companies, taxis, or anyone who bills the KY Medical Assistance Program for health care goods or services provided to a Medicaid recipient. The Office of Medicaid Fraud and Abuse has state and federal authority to bring both criminal and civil actions.
What is the Kentucky Judicial Branch?
The Kentucky Judicial Branch is committed to ensuring public trust and confidence in the state court system by operating in an ethical and transparent manner and being a good steward of taxpayer dollars. This page explains how to report allegations of waste, fraud and abuse involving state court personnel. Complaints will be forwarded to the appropriate entity for investigation.
How to facilitate an investigation?
To facilitate an investigation, you are encouraged to provide your contact information along with specific details about your complaint. Anonymous allegations are more difficult to investigate but will be accepted. Please include the following information: