Tips Page For Reporting Medicaid and Public Assistance Fraud
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Hi, I’m Tom Suozzi, County Executive for Nassau. Public Assistance programs, like Medicaid, Public assistance, Food Stamps, Day Care and HEAP, are a vital resource for many of our residents, but waste, fraud and abuse in these programs cost YOU millions of dollars every year and short change those who need and deserve our help. Won’t you please help us fight those who defraud and abuse these programs? If you know of any provider, business, or person engaged in questionable practices involving public assistance programs, let us know. Speak up! Working together, we can make a difference. |
Nassau County Health and Human Services
60 Charles Lindbergh Blvd, Uniondale, NY |
Section Links:
Public Assistance Fraud And Abuse In Nassau County
What Is Public Assistance Fraud And Abuse?
What Is Nassau County Doing To Help Combat Fraud And Abuse?
Types Of Recipient Fraud
Types Of Provider Fraud
How To Contact Us To Report Fraud And Abuse
Public Assistance Fraud And Abuse In Nassau County
Public Assistance programs like Medicaid are a vital source of help for many Nassau County residents who need and deserve assistance. Unfortunately, there are those who take advantage of these programs and the people they serve by intentionally obtaining money and services they are not entitled to. In fact, the New York Times estimated that somewhere between 10% and 40% of the money spent on the Medicaid program alone is lost to waste, fraud and abuse. That's millions of Nassau County taxpayer dollars down the drain!
If you know of any business or person engaged in questionable practices involving assistance programs, speak up and make a difference. Make a call to the Fraud and Abuse Hotline today!
1-877-711-TIPS (8477)
Or complete the confidential Complaint Form at the bottom of this page.
The source of all tips will be held confidential and it’s even okay if you want to remain anonymous.
What Is Public Assistance Fraud And Abuse?
Fraud and abuse are any intentional actions which result in a recipient or provider receiving benefits or payments to which they are not entitled.
Fraud and abuse significantly and negatively impact the various assistance programs by wasting dollars that could be used to provide services for those people with a legitimate need for assistance.
Programs Impacted By Fraud And Abuse:
Medicaid
Temporary Assistance to Needy Families (TANF)
Safety Net
Food Stamps
Day Care
Child Health Plus
Family Health Plus
Home Energy Assistance Program (HEAP)
Home Care
Nursing Home Care
Medicaid and Public Assistance fraud is a serious crime that can result in imprisonment, probation, civil penalties, and restitution and render someone ineligible for benefits for a certain length of time.
What Is Nassau County Doing To Help Combat Fraud And Abuse?
Nassau County is committed to protecting the quality and integrity of the County’s Medicaid and Public Assistance programs. As such, the Department of Social Services is actively pursing fraud and abuse throughout the various programs. We’ve even created a special team of people who specialize in combating fraud and abuse.
Nassau County’s Medicaid and Public Assistance Fraud and Abuse Program involves a cooperative effort between the Nassau County Department of Social Services, the Nassau County Police Department, the Nassau County District Attorney’s Office, the Nassau County Attorney’s Office and the Nassau County Commissioner of Investigation’s Office, all working together to detect, prevent and deter fraud and abuse and to ultimately prosecute those individuals and providers who defraud or abuse the assistance system.
Our team focuses on two types of fraud, namely Recipient and Provider fraud.
Types of Recipient Fraud:
Examples:
- Providing false or incomplete information to the Department of Social Services at either the application or recertification phase;
- Falsely reporting that a parent is absent from the household;
- Falsely reporting that a child is in the household;
- Listing a non-relative as a family member in order to obtain benefits;
- Intentionally failing to report a change in the household composition;
- Intentionally failing to report earnings from employment or monies received from unemployment, disability or social security;
- Intentionally failing to disclose assets, including bank accounts and real estate;
- Submitting false or fraudulent documents to the Department of Social Services in order to get benefits;
- Using someone else’s benefits card to obtain treatment, services or benefits;
- Claiming coverage for treatments, services or supplies not received;
- Forging or altering a prescription;
- Doctor Shopping to obtain unnecessary prescription medications or durable medical equipment and then selling these items for a profit.
Types Of Provider Fraud:
Providers: Includes physicians, dentists, pharmacists, home care providers, mental health providers, durable medical equipment suppliers, ambulance companies, medical transportation companies, hospitals nursing homes, and day care providers.
Examples:
- Billing for nonexistent or unnecessary medical services, such as x-rays, laboratory tests or drugs that were never dispensed;
- Billing for more expensive products or labor intensive services than were provided;
- Paying kickbacks or providing gifts and other incentives to third parties in exchange for business or referrals to a particular doctor or hospital;
- Inflating of claimed mileage by transportation companies in order to receive greater reimbursement;
- Billing Medicaid for transportation to non-Medicaid services;
- Billing an insurance carrier or patient for the cost of a name brand prescription when a lower costing generic substitute or an over-the-counter drug was instead supplied;
- Deliberately applying for duplicate reimbursement – double billing;
- Billing for more days in a hospital or nursing home than the patient actually stayed;
- Billing services for patients who have died;
- Billing related services separately to charge a higher amount than if services were combined and billed as one service;
- Billing for used items as new items by durable medical equipment companies;
- Continuing to send recipients medical supplies when it is no longer medically necessary.
The team welcomes tips from private citizens as well as employees or colleagues who work with providers who cheat Medicaid or other public assistance programs.
How to Contact Us to Report Fraud and Abuse
Fraud and abuse of public programs affect all of us.
Everyone can take responsibility for reporting suspected fraud and abuse.
If you have reason to believe that someone is abusing Medicaid or another public assistance program, you should report it.
Again, if you prefer, you can submit your complaint anonymously and the source of all fraud and abuse complaints are kept strictly confidential.
There are three ways you can report fraud and abuse of our taxpayer dollars:
- Submit a Complaint On-line by clicking here
 Download, Print and Complete a Complaint Form - mail it to:
Nassau County Department of Social Services
Attn: Special Investigations Unit
60 Charles Lindbergh Blvd.
Uniondale, NY 11553
- Call Our Toll-Free Hotline at (877) 711-TIPS (8477)
IF YOU KNOW SOMETHING, SAY SOMETHING!
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