The Medicaid Fraud & Abuse Control Division investigates provider fraud. Providers include medical doctors, dentists, hospitals, nursing homes, pharmacies, durable medical equipment sellers, ambulance companies, taxis, or anyone who bills the KY Medical Assistance Program for health care goods or services provided to a Medicaid recipient.
Examples of fraud
- Billing for medical services not actually performed
- Billing for a more expensive service than was actually rendered
- Billing for several services that should be combined into one billing
- Billing twice for the same medical service
- Dispensing generic drugs and billing for brand-name drugs
- Kickbacks - giving or accepting something in return for medical services
- Providing unnecessary services
- False cost reports
- Billing for ambulance runs when no medical service is provided
- Multiple passengers in an ambulance and separate billings for each passenger
If you know or suspect that a recipient is defrauding or abusing the Medicaid program, or another assistance program, please notify the Office of the Inspector General.
To make a report, please call the Medicaid & Welfare Fraud & Abuse Hotline at 1-800-372-2970.