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Reporting Fraud and Abuse

Medicaid loses millions of dollars each year because of fraud and abuse.

• Fraud is when a person steals or scams the Medicaid system. An example of fraud might be a person not reporting additional earnings to the Medicaid office. 
• Abuse is when a person does not follow the rules. This causes money to be unnecessarily wasted.

We have a committee to help detect fraud and abuse. The committee looks at things like payments to doctors for their services, doctors' bills for seeing members and members' use of the First Choice ID card.

If you think someone is abusing the Medicaid system, you must report it. To report suspected fraud and abuse, please contact the Corporate and Financial Investigations Unit Fraud Hotline at 1.866.833.9718 or the South Carolina Department of Health and Human Services Fraud and Abuse Hotline at 1.888.364.3224.