Full Text
To make a report Phone: [PHONE REDACTED] or E-mail: [EMAIL REDACTED] 60 Central Ave Cortland NY 13045 http://cchd.cortland-co.org/ We all share the cost of fraud! What You Can Do To Prevent Medicaid or Medicare Fraud A Guide for Cortland County Health Department Consumers Call the OMIG fraud hotline to make an anonymous report: 1-877-87FRAUD (1-[PHONE REDACTED]) For more information you can go online New York State Office of the Medicaid Inspector General http://omig.ny.gov/ Reports can be made directly to OMIG CORTLAND COUNTY HEALTH DEPARTMENT Corporate Compliance Program CORTLAND COUNTY HEALTH DEPARTMENT Reports can be made directly to Cortland County Health Department Compliance Officer If you suspect fraud relating to a Cortland County Health Department service provider, make a report by contacting our Compliance Officer • Reports may be made electronically, by mail, email or phone • Anonymous reports may be made using the same methods listed above • Protections are in place preventing retaliation or intimidation against anyone making a good faith report • ALL reports will be thoroughly investigated ---PAGE BREAK--- OMIG The Office of the Medicaid Inspector General (OMIG) was created in an effort to identify fraud, waste and abuse in the NYS Medicaid Program. While OMIG primarily focuses on the potential for Medicaid fraud, we apply the same standards to Medicare and other 3rd party insurance companies. The Cortland County Health Department has developed a Compliance Program to address this very important issue. Our plan will be provided to you upon request or can be found at our website: http://cchd.cortland-co.org Fraud is a criminal offense... Punishable under federal and state laws. Offenders may be liable for penalties and “per claim” pay back resulting in huge fines and even jail time. WHAT YOU SHOULD KNOW…... What you can An easy way to identify fraud is to keep a record of the following information: 1. When a professional service is used 2. Where the service takes place 3. Who provides the service 4. What procedures were done during that visit 5. What additional testing was ordered by the provider Examples of fraud by a provider….. 1. Billing insurance for a service that was not provided 2. Billing Medicaid first then billing a secondary insurance again for the same service 3. Providing an unnecessary service 4. “Requiring” a return visit that is not necessary 5. Using un-licensed staff but billing for a licensed clinician 6. Billing for more time than the actual visit Examples of fraud by a patient….. 1. Lying about their eligibility for Medicaid 2. Lying about their medical condition 3. Forging a prescription 4. Loaning someone their Medicaid (or any insurance) card 60 Central Ave Cortland NY 13045 http://cchd.cortland-co.org/ To make a report Phone: [PHONE REDACTED] or E-mail: [EMAIL REDACTED] CORTLAND COUNTY HEALTH DEPARTMENT We All Have a Role to Play IF you suspect that fraud, abuse or waste is taking place LET SOMEONE KNOW! Contact the Cortland County Health Department Corporate Compliance Officer