Bruce Mandelblit
Tuesday, Dec. 31, 2002

Medicaid fraud – it's a really big criminal enterprise.

How big?

The FBI estimates that 10 cents of each dollar spent on Medicaid each year is lost to fraud and abuse. That translates to over $10 billion a year in losses to the U.S. taxpayer.

How is Medicaid defrauded?

Here are some of the most common rip-off schemes, according to the Centers for Medicare and Medicaid Services (CMS):

1. Billing for "phantom patients" who did not really receive services.

2. Billing for medical services or goods that were not provided.

3. Billing for old items as if they were new.

4. Billing for more hours than there are in a day.

5. Billing for tests that the patient did not need.

6. Paying a "kickback" in exchange for a referral for medical services or goods.

7. Charging Medicaid for personal expenses that have nothing to do with caring for a Medicaid client.

8. Overcharging for health care services or goods that were provided.

9. Concealing ownership in a related company.

10. Using false credentials.

11. Double-billing for health care services or goods that were provided.

Here are some useful tips from CMS:

1. Look at your Medicaid bill carefully to make sure that Medicaid has been billed only for medical services or goods that you received.

   A Quick Security Tip: Check to see that the date of service is correct.

2. DO NOT give your Medicaid card number to anyone except your doctor, clinic, hospital or other health care provider.

3. DO NOT ask your doctor or other health care provider for medical care you do not need.

4. DO NOT share your Medicaid records or other medical information with anyone except your doctor, clinic, hospital or other health care provider.

5. If you are offered free tests or screenings in exchange for your Medicaid card number, be suspicious.

6. If it sounds too good to be true, it probably is. Be careful about accepting Medicaid services when you are told they will be free of charge.

7. If anyone claims they know how to make Medicaid pay for health care services or goods that Medicaid usually does not pay for, you should avoid them.

8. DO NOT let anyone borrow your Medicaid card.

A Final Thought: Medicaid fraud is a corrupt criminal drain on all taxpayers. It appears, in fact, that organized crime is involved in Medicaid fraud because it offers a high cash return with a lower chance of detection than many other types of crime.

If you suspect Medicaid fraud, be sure to make the effort to contact your state Medicaid agency or call the National Fraud hotline at 1-800-HHS-TIPS (1-800-447-8477).

Only with the vigilance and assistance of Medicaid consumers and health care providers can we, as a country, help fight Medicaid fraud and put these horrendous Medicaid criminal scum out of business and into prison!

Copyright 2003 by Bruce Mandelblit

"Staying Safe" with Bruce Mandelblit is a regular column for the readers of NewsMax.com and NewsMax.com magazine.

Bruce welcomes your security, safety and crime prevention questions. He will answer questions of general interest in his column. CrimePrevention123@yahoo.com.

Bruce is a nationally known security specialist, as well as a highly decorated reserve Law Enforcement Officer.

Bruce was recently commissioned as a Kentucky Colonel – the state's highest honor – by Gov. Paul E. Patton – for his public service.

This column is provided for general information purposes only. Please check with your local law enforcement agency and legal professional for information specific to you and your jurisdiction.

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