Medicaid providers include doctors, dentists, hospitals, nursing homes, pharmacies, clinics, counselors, personal care/homemaker chore companies, and any other individual or company that provides services to Medicaid participants. Medicaid fraud occurs when a provider misrepresents the services rendered and thereby increases the reimbursement from Missouri Medicaid. 

• Billing for any services not actually performed, known as phantom billing;
• Billing for a more expensive service than was actually rendered, known as upcoding;
• Billing for several services that should be combined into one billing, known as unbundling;
• Billing twice for the same medical service;
• Dispensing generic drugs and billing for brand-name drugs;
• Giving or accepting something in return for medical services, known as a kickback;
• Bribery;
• Billing for unnecessary services;
• Submitting false cost reports; and
• Falsifying timesheets or signatures in connection with the provision of personal care or consumer directed home health services.
       

You may report Medicaid fraud by using any of the following methods:

• Call toll free at (800) 286-3932
• Fill out and submit an online complaint form

Download, complete, and mail a  complaint form to:

Missouri Attorney General's Office
Medicaid Fraud Control Unit
P.O. Box 899
Jefferson City, MO 65102

If you are the original source of information used by the Attorney General to file a civil suit against a Medicaid provider, you may be entitled to 10 percent of the State’s share of the amount recovered as a result of the suit.