
Medicaid fraud and abuse is when a person knowingly cheats or is dishonest. The dishonesty results in a benefit such as payment or coverage.
Examples of Medicaid fraud and abuse:
You are encouraged to report matters involving Medicaid fraud and abuse. If you want to report fraud or abuse, you can remain anonymous. However, sometimes in order to conduct an effective investigation, staff may need to re-contact you. Your name will not be shared with anyone investigated. (In rare cases involving legal proceedings, we may have to reveal who you are.)
If you have been denied benefits and disagree with this decision, you may ask for an appeal. Contact your worker at the Department of Social Services who sent the letter denying benefits. If you are uncertain whom to call, contact the CARE-LINE Information and Referral Service: 1-800-662-7030, or, (919) 855-4400 in Wake County.
Medicaid recipients are entitled to have their medical information be kept private. See Notice of Privacy Practices (DMA-2188).