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COMAR 10.09.24.14

1403 State of Maryland Medical Assistance Manual Revised July 2012

Section 1400 Frequently Asked Questions and Answers (FAQs) Fraud and Abuse

1. What does the Medicaid Program Integrity (PI) Division Investigate? They investigate allegation of possible Medicaid recipient fraud. 2. Where should a completed DHMH Form 4243 be sent? To: Department of Health and Mental Hygiene Office of the Inspector General – Medicaid Program Integrity 201 West Preston St., Rm. 520 Baltimore, MD 21201 3. What are some resources to obtain referrals for investigation of suspected recipient fraud?

Providers, police departments, the Social Security Administration, and citizens 4. What are some examples of the most frequent types of recipient fraud? Intentionally under-reporting or not reporting income and resources; Falsely reporting household composition, such as omitting wage earners from the Medicaid application; Failing to report changes in income, resources, or other circumstances within 10 days as required – e.g., moving out of state, receipt of cash lump sums; and Failing to report third party insurance coverage. 5. What is the website and phone number where you can report Medicaid Fraud? Website: www.DHMH.Maryland.Gov/oig/sitepages/home.aspx Contact number: 1-866-770-7175