What is Medicaid Fraud

Fighting Fraud. Improving Integrity and Quality. Saving Taxpayer Dollars

OMIG detects schemes of fraud, curbs unacceptable practices, and improves quality of care as it relates to Medicaid fraud, waste, and abuse. Investigations focus on finding those providers who commit fraud and abuse to ensure that these individuals will no longer be able to participate in the State's Medicaid program. Fraud and abuse discoveries result in the initiation of an administrative action or a referral for civil and criminal prosecution. Administrative actions include the exclusion or termination of providers from the Medicaid Program, monetary penalties, recovery of Medicaid funds, and suspension of Medicaid privileges for a specified period of time. Provider issues that could result in criminal prosecution are referred to the Arkansas Attorney General's Medicaid Fraud Control Unit (MFCU) for possible criminal prosecution.

Investigations are also conducted on allegations related to Medicaid consumer eligibility, misuse of benefits cards, and cases where consumers lend or rent their benefits cards to others to obtain medical benefits for which they are not entitled. OMIG also coordinates with local, state, and federal law enforcement to investigate consumers defrauding Medicaid and refers those consumers for prosecution.

If you suspect fraud or abuse, call toll free: 1-855-5AR-OMIG (1-855-527-6644)