If you, the small health care provider, are accused of Medicare or Medicaid fraud, tell the government even the States over-bill for Medicaid services!

Wednesday, October 1, 2014

If you, the small health care provider, are accused of Medicare or Medicaid fraud, tell the government even the States over-bill for Medicaid services!

By way of background, the Medicaid program provides assistance to certain low-income and disabled individuals. The Federal and State governments jointly fund and administer the Medicaid program. The Federal Government pays its share of a State’s Medicaid payments based on Federal medical assistance percentages (FMAP), which varies depending on the State’s relative per capita income.

In September 2014, the Office of Inspector General (OIG) reported that it had audited approximately 5.5 million Massachusetts Medicaid claims, totaling $3.8 billion. Of the 5.5 million claims audited, approximately 2.4 million used the wrong FMAP; an incredible 43%! As a result, Massachusetts will be forced to reimburse the federal government $105 million. http://oig.hhs.gov/oas/reports/region1/11300003.pdf.

If you get jammed up for Medicare or Medicaid fraud, please call me, 267-253-7933.