This PPT by the Health 2.0 Conference offers a 360-degree view of Medicaid scams, fraud, and spam, and how innocent people can avoid becoming victims while trying to access quality healthcare services.

1. A Guide to Understand
Medicaid Fraud & Scams
A Review From Health 2.0 Conference

2. Table of
Contents
● What is Medicaid?
● What is Medicaid Fraud?
● Most Common Types of
Medicaid Scams
● Red Flags Of Medicaid Scams

3. What is Medicaid?

4. ● Medicaid is a government-funded assistance programme.
● It mainly benefits low-income people of all ages.
● Mostly, patients do not have to worry about any of the expenditures associated
with reimbursed medical expenses.
● Occasionally, a minor co-payment is required.
● Medicaid is a joint federal-state initiative.
● It differs from one state to the next. It is generally administered by the state
governments complying to the federal regulations.

5. What is Medicaid Fraud?

6. Eminent international health awareness conferences like Health 2.0 Conference
talk about Medicaid Fraud. Here are some of the stated definitions:
● The intentional provision of false information to get Medicaid to pay for medical
care or services is known as Medicaid fraud.
● One sort of fraud is medical identity theft.
● It entails obtaining health care goods, services, or finances using another
person's medical card or information.
● The intentional provision of false information to get Medicaid to pay for medical
care or services is known as Medicaid fraud.
● One sort of fraud is medical identity theft. It entails obtaining health care goods,
services, or finances using another person's medical card or information.

7. Most Common Types of Medicaid Scams

8. Unnecessary Services:
Medicaid covers only medically essential procedures or fees. So, consider yourself trapped in a scam if your
doctor suggests an approach that is minimal or not related to your condition.
Failure to Properly Charge Medicaid Patients for Prescriptions:
Global wellness conferences like Health 2.0 Conference suggest that if a pharmacist charges extra from
Medicaid patients, this can be termed a violation or a scam. Program rule violation can lead to a successful
False Claims Act action against the pharmacist.
Examinations Performed by Nurses & Charged As Per the Doctor’s Rate:
Allowing nurses or office staff to handle essential outpatient treatments while paying the government for
the cost of the doctor's time to perform the work is an expanding unlawful trend.
Upcoding:
It entails invoicing for services never supplied or billing for the patient's benefit when a similar but less
expensive service was rendered.

9. Red Flags of Medicaid Scams

10. ● Offer "free" consultations in exchange for your Medicaid card number.
● Attempt to persuade you to purchase more expensive services.
● Charge Medicare for services or equipment you didn't get or aren't
entitled to.
● Use telemarketing or door-to-door sales as marketing strategies.
● Firm claim to be from the government or perform employ fear tactics.

11. Thank You!
This presentation was prepared by
Bhawna Lawera,
Manager, Health 2.0 Conference
https://www.health2conf.com/