A new website and hotline will make it easier for Wyoming residents to report potential Medicaid fraud.
Operated by the Wyoming Department of Health, Medicaid is a joint federal and state government program that pays for medical care for some low-income and medically needy individuals and families.
The new website can be found online at stopwyomedicaidfraud.com; the hotline can be reached at 1-855-846-2563. Both efforts are intended to strengthen the ongoing work by Wyoming Medicaid and the Wyoming Attorney General’s Medicaid Fraud Control Unit to combat Medicaid fraud in the state.
Regina Cox, quality assurance manager with the Wyoming Department of Health’s Division of Healthcare Financing, said the website allows for simple, anonymous reporting of suspected fraud. “We want to help people understand fraud by describing what fraud is and by offering examples of the kinds of improper things we want to find and stop from happening,” she said.
Cox said there are two basic categories of Medicaid fraud: provider fraud and client fraud.
“With provider fraud, a Medicaid provider knowingly makes a false or misleading statement or representation so they can get money from the program,” she said. “Examples include billing for services they didn’t really do, billing twice, false cost reports, providing generic medicines but billing for name-brand drugs, falsifying timesheets or embezzlement.”
Client fraud occurs when a Medicaid client tries to bill services to Wyoming Medicaid for someone who is not eligible and enrolled with the program, or when someone who is not on Medicaid uses the personal information or identification of a Medicaid client to receive services.
Christine Stickley, senior assistant attorney general and director of the Medicaid Fraud Control Unit, said many cases investigated and eventually prosecuted by the Medicaid Fraud Control Unit start with information submitted by private citizens. “That’s why we want more than one way for people to easily report fraud and we want it to be user friendly. The new website and the hotline together offer those options.”
Cox said the website and hotline illustrate Wyoming is continuing efforts to protect Medicaid clients. “When dishonest healthcare providers and patients steal from Wyoming Medicaid, they decrease the resources we have available to help our clients, who are often among our state’s most vulnerable citizens.”