State of California California Department of Consumer Affairs

Medicaid

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Revision as of 21:51, 14 March 2011

814-Other Federal Agencies

MEDICAID

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The Medicaid is a jointly-funded, Federal-State health insurance program for certain low income and needy people. It covers approximately 37 million individuals including children, the aged, blind, and/or disabled, and people who are eligible to receive federally assisted income maintenance payments. The Health Care Financing Administration (HCFA), a federal agency, mandates certain eligibility classes and quality of care standards with the bulk of the administrative functions being carried by the State.


US Department of Health and Human Services
Center for Medicare and Medicaid Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
(202) 619-0257
(877) 696-6775
www.os.dhhs.gov


Medi-Cal is California’s Medicaid health care program. This program pays for a variety of medical services for children and adults with limited income and resources. Medi-Cal is supported by federal and state taxes.


California Department of Health Care Services:
P.O. Box 997413, MS 4400
Sacramento, CA 95899-7413
(916) 445-4171
www.dhcs.ca.gov


Reporting Medi-Cal Fraud:

The primary contact for reporting suspected fraud, whether perpetrated by an individual or agency is the California Department of Health Care Services (DHCS). DHCS is the state agency responsible for policing fraud in the Medicaid program.


Department of Health Care Services
Medi-cal Fraud and Abuse
P.O. Box 997413, MS 4000
Sacramento, CA 95899-7413
(800) 822-6222 www.dhcs.ca.gov
Email - stopmedicalfraud@dhcs.ca.gov
On-Line Complaint form


A second, less direct contact, is the US Department of Justice, Office of Inspector General's National Fraud Hotline to report both Medicaid and Medicare Fraud.


US Department of Justice
Office of Inspector General's National Fraud Hotline
(800) 869-4499
www.usdoj.gov


Consumers should have the following information before writing the California Department of Health Services or calling the National Fraud Hotline.

  1. Recipient's name
  2. Recipient's Medicaid number
  3. Provider's name
  4. Date of service
  5. Amount approved by Medicaid
  6. Description of fraudulent or abusive acts


See Also:
Medi-Cal
Medicare



Consumer Resource & Referral Guide Consumer Resource & Referral Guide
Directory of State Agencies Directory of State Agencies
Directory of Federal Agencies Directory of Federal Agencies
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