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Reporting Fraud, Waste and Abuse

Magnolia Health is serious about finding and reporting times that Mississippi Medicaid funds are used in the wrong way. This is called waste, fraud or abuse.

Fraud means to knowingly get benefits or payments that you are not entitled to receive. Please let us know if you are aware of someone who is committing fraud. This could be a provider or a member. Some examples of health care fraud include:

  • A lie on an application
  • Using someone else's ID card
  • A provider (doctor) billing for services that were not done
  • Transportation (usage abuse)

Waste is the overuse of services that may result in costs not needed for health care benefits. This includes direct costs and indirect costs. Waste usually results from the misuse of services.

Abuse is actions that may result in unnecessary costs not needed for health care benefits. This includes direct costs and indirect costs. Abuse involves payment for items or services when there is no legal reason for to pay for them.

Magnolia is serious about finding and reporting fraud and abuse. Our staff is available to talk to you about this. Here is the address and phone numbers:

Magnolia Health
Compliance Department
111 East Capitol Street, Suite 500
Jackson, MS 39201

Or you can call Magnolia’s Waste, Abuse, and Fraud Hotline at 1-866-685-8664.

You can also report fraud and abuse to Medicaid. Medicaid’s address and phone number are:

Division of Medicaid
Office of the Governor
Attn: Office of Program Integrity
550 High Street, Suite 1000
Jackson, Mississippi 39201
Ph: 601-576-4162 or 1-800-880-5920
Fax: 601-576-4161

To report waste, abuse, or fraud, gather as much information as possible.

When reporting about a provider (a doctor, dentist, counselor, etc.) include: 

  • Name, address, and phone number of provider
  • Name and address of the facility (hospital, nursing home, home health agency, etc.)
  • Medicaid number of the provider and facility, if you have it
  • Type of provider (doctor, dentist, therapist, pharmacist, etc.)
  • Names and phone numbers of other witnesses who can help in the investigation
  • Dates of events 
  • Summary of what happened

When reporting about someone who gets benefits, include: 

  • The person’s name
  • The person’s date of birth, Social Security Number, or case number if you have it 
  • The city where the person lives 
  • Specific details about the waste, abuse, or fraud