Welfare Fraud

Published

I work in HH. The pt admitted to withholding information to obtain medical. But as I work with them longer, I've found they have an absurdly high income d/t 3 rental properties in Cali. They also just put 100k on a new home here. They have an income of 10k a month. They receive all forms of assistance, even foodstamps. What would you do if you saw this? The family is one child, two adults. Is it HIPPA violation to report? I don't know how they get away with it, but my state is very lax about checking info. I see the medical part justified for the pt. but the whole family?? It's hard to watch. They have a very entitled mentality. Any advice?

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Can you report it to Medicaid? I also worked in HH and also saw similar things. People living a better life than I do, driving better cars, 50" flats in each room, name brand purses and shoes while I shop at Ross and work my assignment off. Every tax season they'd get new furniture etc. It was hard to watch. I wonder how they do it or if they're in debt and don't care.

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Specializes in Complex pedi to LTC/SA & now a manager.

Medicaid Fraud isn't covered by HIPAA. You may be a mandated reporter. Check your state. You can always call anonymously

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as beachy said, fraud is not excused by HIPAA. report anon, if possible, to protect your job.

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Specializes in Critical Care.

There are a number of ways of reporting fraud, google "reporting welfare fraud", "reporting medicaid fraud", etc. And as others have said, it's not HIPAA protected.

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Specializes in Med/Surg, Ortho, ASC.

Please do report.

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Specializes in LTC, assisted living, med-surg, psych.

Yes, report it ASAP. It's people like that family who make it hard for those of us with legitimate needs. Shame on them!

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Report if you feel moved to do so. Think three times before making any comments to your agency though. If you do not want to deal with consequences, and there will be consequences for you if you report, then find another case, with or without reporting.

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Specializes in ER.

Report it!

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Specializes in progressive care. med surg. tele. LTC. psych..

I would just think about the child..

Would they suffer? Would they be without medical?

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I would just think about the child..

Would they suffer? Would they be without medical?

I would think with an income of $10K per month they could afford health insurance/medical bills.

I would definitely report it. They are abusing the system.

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I would be frustrated, but wonder what loopholes they might be exploiting. Who's name are the rental properties in? Who's name is their house in? Are the designer clothes and shoes "gifts"? Unfortunately, it seems like there are a lot of legal ways to commit fraud. Good luck.

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