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The Medicaid Fraud Control Unit possesses both criminal and civil authority. The criminal units investigate and prosecute Medicaid providers that submit fraudulent billing to the state program. The unit receives referrals from the Oklahoma Health Care Authority as well as calls from concerned citizens.
The Medicaid Fraud Control Unit is also tasked with investigating abuse, neglect and exploitation of residents in Medicaid paid nursing homes. Most referrals come from the Department of Health. However, the unit also receives information from local law enforcement, concerned family members, and hotline tips.
Oklahoma statutes provide for “whistleblower” claims. These claims are brought by private citizens on behalf of the State. The civil function of the Medicaid Fraud Control Unit represents the State’s interest in these cases. The civil unit also files lawsuits against providers that submit fraudulent claims against the Medicaid program.
If you suspect Medicaid provider fraud or abuse, neglect or exploitation of a nursing home resident, call the hotline at (405) 522-2963.