The Agency for Health Care Administration is responsible for coordinating Medicaid overpayment and abuse prevention, detection and recovery efforts. The Attorney General's office is responsible for investigating and prosecuting Medicaid fraud.
Below are some links that provide additional information:
- Medicaid Fraud: Protect Your Tax Dollars: This link directs you to the Agency’s Inspector General’s guidance in helping you understand the importance of reporting Medicaid fraud. It also provides links to additional resources about Medicaid fraud, abuse, and overpayments
- Report Medicaid Abuse and Overpayment: The following links are available to assist you in reporting Fraud, Abuse, and Overpayments. You are also directed to information about the Agency’s Bureau of Medicaid Program Integrity.
Medicaid Provider Self Audits: Providers who would like more information about conducting self audits should contact the Agency‘s Office of Inspector General, Bureau of Medicaid Program Integrity’s Self Audit Coordinator, Pam Fante, at Pam.Fante@ahca.myflorida.com or the Division of Medicaid, Fraud and Abuse Liaison, Kelly Bennett, at Kelly.Bennett@ahca.myflorida.com. Additional resources are available to assist in conducting self audits, such as the MPI self audit guide [PDF 35KB], a Medicaid compliance video, and a provider self audit example [PDF 30KB].
Additionally, information about self audits and other compliance-related issues are published in the Medicaid Provider Bulletins. Bulletins include “Medicaid Compliance Corner”, a series of articles addressing provider obligations to ensure compliance with program rules and other substantive policy matters that are relevant to providers’ compliance efforts.