Medicaid is a federal program administered by the states that allows people who earn low incomes to get access to health care. Here in Colorado, the program is called Health First Colorado. Well over 1 million Coloradans rely on Medicaid for their health care coverage.
What is Medicaid fraud?
Medicaid fraud happens when someone attempts to obtain more benefits or payments than they are entitled to under the law for the purposes of personal gain. Whether through false statements, willful misrepresentation, concealing information, or engaging in fraudulent schemes, Medicaid fraud can cost all of us millions of our tax dollars.
Does the Colorado Attorney General’s Office investigate individual Medicaid patients?
The Medicaid Fraud Control Unit focuses its efforts on providers engaging in fraud and does not investigate individual Medicaid patients. If you are suspicious of Medicaid recipient fraud, contact your county human services department or whichever local office administers your county’s Medicaid services.
Does the Colorado Attorney General’s Office investigate Medicare-related fraud?
Are there protections for Medicaid fraud whistleblowers?
The law provides certain protections for Medicaid fraud whistleblowers. For more information on what protections might apply to your situation, you should consult an attorney of your choice.
What if providers are engaging in abuse or neglect of Medicaid patients?
In addition to investigating fraud, the Medicaid Fraud Control Unit also investigates allegations of patient neglect and abuse by Medicaid providers.
If you suspect a Medicaid patient is being abused or neglected, or that a patient’s funds are being used improperly, call local law enforcement. If you believe the abuse or neglect involves a Medicaid funded facility or provider, report it.
How do I report Medicaid fraud, and patient abuse or neglect?
