October 24, 2014
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AG Kilmartin urges public to report Medicaid fraud, patient abuse

With Medicaid accounting for the single largest portion of the state’s fiscal budget with a line item of approximately $1.4 billion in state tax dollars, Attorney General Peter Kilmartin has urged the public and patients to report Medicaid fraud and patient abuse with a new online complaint form.

Available at www.riag.ri.gov, the newly-created Medicaid Fraud and Patient Abuse Complaint Form allows individuals to report instances of Medicaid fraud and patient abuse electronically to the Attorney General’s Medicaid Fraud Control and Patient Abuse Unit for investigation and referral.

“We know there is fraud and abuse in the Medicaid system, but it often goes unreported because citizens may not know where to turn for help,” said Attorney General Kilmartin. This online complaint form is a valuable resource for patients, families, health professionals and all taxpayers to report possible fraud in our Medicaid system.

The Medicaid Fraud and Patient Abuse Complaint Form enables constituents to submit information regarding the subject of the complaint, the suspected fraud and a brief description of the events that occurred. Complaints are reviewed on a daily basis by members of the Medicaid Fraud Control and Patient Abuse Unit. Forms may also be submitted anonymously by the complainant. In addition to the online form, individuals may continue to contact the Medicaid Fraud Control and Patient Abuse Unit at 401-274-4400, extension 2269.

The Attorney General’s Medicaid Fraud Control and Patient Abuse Unit enforces the laws pertaining to fraud in the state Medicaid program and prosecutes cases of abuse, neglect or mistreatment of patients in all state health care facilities. The Unit prosecutes criminal activity, pursues civil remedies where appropriate and participates with federal and state authorities in a variety of inter-agency investigations and administrative proceedings. The Unit’s attorneys, auditors, investigators and health care professionals employ a multi-disciplinary approach to combat health care fraud and patient abuse.

The Unit works closely with federal and state authorities to investigate pharmaceutical companies who overbill and de-fraud the states Medicaid program. In 2011, the Unit returned $1.16 million to the states Medicaid program in settlement agreements with pharmaceutical companies, including a $562,910 settlement with CVS to resolve allegations that the company overcharged Medicaid for prescription drugs, and investigated 60 cases of patient abuse and neglect.


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