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Medicaid Fraud and Patient Abuse UnitNebraska Attorney General

Medicaid Fraud and Patient Abuse UnitNebraska Attorney General 2025

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The document is an Incident Report / Case Referral form for the Nebraska Medicaid Fraud Control Unit, designed to report suspected fraud, patient abuse, neglect, or issues related to patient trust funds. It includes sections for personal information of the referrer, details about the facility or provider involved, victim/patient information if applicable, and a description of the allegations or concerns. Additionally, it prompts the referrer to indicate any other agencies that have been notified regarding the incident.

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How to combat Medicare fraud?

Do: Protect your Medicare Number and your Social Security Number. Guard your Medicare card like its a credit card. Become familiar with how Medicare uses your personal information. Check the receipts and statements you get from providers for mistakes, and call your providers office if you think a charge is incorrect.

What is the most common Medicare fraud?

Medicare fraud happens in many ways. It most commonly occurs in: Billing for institutional facilities such as nursing homes, residential facilities, hospitals, home health, and hospice. Billing for physician visits and services not rendered or not medically necessary.

What does the Medicaid Fraud Control Unit do?

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud as well as abuse or neglect of residents in health care facilities and board and care facilities and of Medicaid enrollees in noninstitutional or other settings.

Which office fights Medicare fraud and abuse?

Since its 1976 establishment, the Office of Inspector General (OIG) has been at the forefront of the Nations efforts to fight waste, fraud and abuse and to improve the efficiency of Medicare, Medicaid and more than 100 other Department of Health Human Services (HHS) programs. OIG has approximately 1,600 personnel.

How is Medicare fraud investigated?

UPICs are private entities contracted by the CMS to perform program integrity activities for Medicare and Medicaid. They detect and deter fraud, waste, and abuse within these programs. UPICs conduct audits and investigations and make referrals to the CMS and law enforcement when they identify potential fraud.

Can you sue for Medicaid fraud?

To report fraud, the Medicaid whistleblower files a quit tam lawsuit against the perpetrator of the fraud. Qui Tam cases fall within the purview of the False Claims Act which is a key whistleblower law enabling citizens to sue on behalf of the taxpayers and the government, as well as themselves.

What is the Medicaid False Claims Act in Nebraska?

The Nebraska Medicaid False Claims Act, (NMFCA) makes it unlawful for any person to commit any of the following acts in relation to the Nebraska Medicaid program: (a) knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval; (b) knowingly makes, uses, or causes to be made or

Medicaid Fraud and Patient Abuse UnitNebraska Attorney General 2025

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