Medicaid is a program funded by state and federal government to make medical services available to those who cannot afford such services. Thus, Medicaid fraud is the securing or attempting to secure payments from the Medicaid program in excess of legally allowable amounts by enrolled providers.

The mere suspicion that a medical provider may have received or tried to receive Medicaid payments in excess of legally allowable amounts is all that is needed as a basis to make a report of suspected fraud. The name of the provider or other potentially identifying data is necessary as well.

It is the improper treatment, assault, neglect or financial exploitation of a patient in a Medicaid provider facility such as a hospital, nursing home or assisted living facility.

Both state and federal law grant limited jurisdiction to the Medicaid Fraud Control Unit to investigate allegations of patient abuse in Medicaid facilities in addition to actual Medicaid provider fraud allegations.

Patients with a mental or physical impairment are most vulnerable and least able to defend themselves.