Job & Family Services - Ohio Health Plans
Ohio Health Plans

Medicaid Fraud Elements

Element MonitoredGeneral RuleNursing RuleDaily Living Service Rule
Falsified provider application and/or records5101:3-1-17.25101:3-12-06 (A)(9)(ii)5101:3-12-06 (B)(6)(a)
Falsified kinship(Consumer) 5101:3-12-12 (A)(2)5101:3-12-06 (A)(9)5101:3-12-06 (B)(6)
Billing for multiple consumers in the same time period5101:3-1-29 (D)  
Billing for services not provided5101:3-1-29 (D)  
Billed hours greater than 24 hours per day5101:3-1-29 (D)  
Kickback to the consumer5101:3-1-29 (D)  
Billed Medicaid for the patient liability 5101:3-12-06 (A)(9)5101:3-12-06 (B)(6)

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