What are some common examples of fraud?
Providers
- Billing for services not rendered
- Paying a "kickback" in exchange for a referral for medical services or goods
- Unbundling
- Overcharging for services or goods
- Using false credentials
Members
- Allowing unauthorized individuals to use ID card to obtain benefits
- Altering prescriptions
- Falsifying residence information to obtain benefits
- Drug seeking or doctor shopping to obtain narcotics