We want to make sure your health care dollars are used right. Fraud and abuse can make health care cost more money for everyone. Fraud and abuse can be done by anyone.
What is Fraud and Abuse?
Fraud is when a person does something on purpose so that the person gets something he or she shouldn't. If a person tries to get health care from a doctor by using another person's HOME Medicaid card, that is one type of fraud. Another type of fraud is if a doctor bills HOME on purpose for a service that wasn't done.
Abuse is when a person does something that costs HOME or the Medicaid program extra money. If a HOME member goes to the emergency room when it isn't really an emergency, that is one type of abuse. Another type of abuse is when a doctor does more services than the patient needs.
What can I do to stop fraud and abuse?
- Do not give your ID number to anyone except your doctor or provider.
- Do not ask your doctor or other provider for health care that you do not need.
- If you are offered free health care in exchange for your ID card number, call the HOME Program.
- If someone says they know how to make HOME pay for health care that we do not pay for, please call us.
- Do not let anyone use your ID card.
- Call us if a provider tries to make you pay for your care (except for your co-pay if you have one).
What can I do if I suspect fraud and abuse?
Call HOME’s Compliance Officer at (801) 587-3108 or (801) 587-3109. You don't even have to tell us your name if you don't want to.