Report Fraud and Abuse
​​​ What is Medicaid Fraud?

Medicaid fraud occurs anytime an individual or provider submits a false claim or intentionally deceives someone in order to obtain coverage and/or payment for services.

Abuse of the Medicaid program occurs when an individual or provider engages in activities that result in unreasonably or excessive cost.

Examples of Medicaid fraud and abuse are:

  • The use of a Medicaid ID card by someone other than the Medicaid recipient;
  • A provider bills for services that were not provided;
  • A provider performs and bills for services that are not medically necessary;
  • A provider's reported credentials are not accurate; or
  • Accepting kickbacks for patient referrals. ​
Dos and Don'ts

  • DO review your Medicaid bill carefully to ensure charges and dates of service are correct
  • DO ask for a copy of everything you sign
  • DON'T let anyone borrow or use your Medicaid card number
  • DON'T ask your doctor or other healthcare provider for treatment or care that you do not need
  • DON'T share your medical records or other medical information with anyone except a doctor, clinic, hospital, or other healthcare provider

How to Report Suspected Healthcare Fraud and Abuse

We encourage you to report any activity you believe may constitute Medicaid fraud or abuse. Cardinal Innovations provides reporting options that allow you to remain anonymous, if you choose.

To facilitate our investigation, it is helpful to have as much information as possible. This information can include:

  • Name of Medicaid recipient and Medicaid ID number
  • Name of healthcare provider
  • Date(s) of service
  • Amount of money Medicaid approved and/or paid
  • Description of the acts that you suspect involve fraud or abuse


How can I Report Suspected Fraud or Abuse to Cardinal Innovations?

​​Telephone: 
​Call our toll-free Fraud and Abuse Line to leave a confidential voicemail at

​1.800.357.9084

Online:

Complete our Suspected Fraud and Abuse Reporting Form >

Mail: ​Write to us at:​
Cardinal Innovations Healthcare
Attention: Program Integrity Unit
550 S Caldwell St, Suite 1500
Charlotte, North Carolina 28202