Report Medicaid Fraud/Abuse

The Centers for Medicare & Medicaid Services and Washington State Office of the Attorney General work diligently to detect, stop, and prevent the fraudulent and wasteful use of Medicare and Medicaid dollars. Fraud is defined as the billing of the Medicaid program for services or items that are unnecessary, not performed or of low quality, or more costly than those performed/used. The most common types of fraud and abuse in Medicaid programs (according to CMS) include:

  • Medical identity theft
  • Billing for unnecessary services and items
  • Billing for services or items not rendered
  • Upcoding
  • Unbundling
  • Billing for non-covered services or items
  • Kickbacks
  • Beneficiary fraud

NCWBH is committed to preventing fraud and abuse by employing ethical business strategies within the guidelines established by all applicable Federal and State laws. Our Compliance Plan outlines these efforts. If you suspect the activities of any of our contractors, network providers, practitioners, or other affiliated persons or organizations may be considered Medicaid Fraud or Abuse, please report these concerns to NCWBH Compliance Officer at 509-886-6318. You may also contact the Compliance Officer to ask questions or learn more about Medicaid Fraud and Abuse and what NCWBH is doing to prevent misuse of Medicaid funding.

You may also report your concerns directly to the Washington State Medicaid Fraud Control Unit:
Phone: (360) 586-8888
Fax: (360) 586-8877
Email: MFCUreferrals@atg.wa.gov
Mail:
Office of the Attorney General
Medicaid Fraud Control Unit
PO Box 40114
Olympia, WA 98504