Is this criminal fraud

[LdiJ]

I totally disagree that she has committed any Medicaid fraud. If she qualifies for Medicaid it becomes secondary insurance and can cover copays and things of that nature not covered by regular health insurance. Its also NOT a "debit card" as suggested by the OP.

Where she may be doing something wrong is against the OP because she is turning around and turning receipts into him that have already been covered by secondary insurance. She can and should be penalized for that, but if he tries to go after her for Medicaid fraud, when there is no fraud, then that's just going to make him look bad.

 

[Taxing Matters]

I totally disagree that she has committed any Medicaid fraud.

We simply do not have any facts to know one way or the other. Medicaid fraud means making material misrepresentations to the government to obtain benefits for which she was not otherwise entitled to get and we don’t know what she put on her application for the benefits. I agree that seeking reimbursement from him for what Medicaid paid is not itself Medicaid fraud, though it could be a fraud against him.

 

[quincy]

I totally disagree that she has committed any Medicaid fraud. If she qualifies for Medicaid it becomes secondary insurance and can cover copays and things of that nature not covered by regular health insurance. Its also NOT a "debit card" as suggested by the OP.

Where she may be doing something wrong is against the OP because she is turning around and turning receipts into him that have already been covered by secondary insurance. She can and should be penalized for that, but if he tries to go after her for Medicaid fraud, when there is no fraud, then that's just going to make him look bad.

Both known fraud and suspected fraud can (and should) be reported to authorities and investigated. You don't "look bad" for making reports to authorities of crimes you suspect may have been committed.

stephensel doesn't know enough to say definitively that his wife has committed Medicaid fraud and we CERTAINLY don't know enough to say definitively that there has or hasn't been Medicaid fraud.

 

[Just Blue]

I totally disagree that she has committed any Medicaid fraud. If she qualifies for Medicaid it becomes secondary insurance and can cover copays and things of that nature not covered by regular health insurance. Its also NOT a "debit card" as suggested by the OP.

Where she may be doing something wrong is against the OP because she is turning around and turning receipts into him that have already been covered by secondary insurance. She can and should be penalized for that, but if he tries to go after her for Medicaid fraud, when there is no fraud, then that's just going to make him look bad.

Interesting. Please provide the GA Stat's or caselaw to support your opinion.


i'll wait.


**************....

 

[quincy]

Interesting. Please provide the GA Stat's or caselaw to support your opinion.


i'll wait.


**************....

Put on a pot of coffee. I suspect you will be waiting a long time.

 

[quincy]

I totally disagree that she has committed any Medicaid fraud. If she qualifies for Medicaid it becomes secondary insurance and can cover copays and things of that nature not covered by regular health insurance. Its also NOT a "debit card" as suggested by the OP.

Where she may be doing something wrong is against the OP because she is turning around and turning receipts into him that have already been covered by secondary insurance. She can and should be penalized for that, but if he tries to go after her for Medicaid fraud, when there is no fraud, then that's just going to make him look bad.

There is a debit card - at least, that is what Georgia's health plans call it.

https://dch.georgia.gov/sites/dch.georgia.gov/files/related_files/site_page/Final Version 2017 CMO Comparison Chart.pdf

Doing just a little bit of research before posting can help you eliminate some of the misinformation you post. Thanks.

 

[Just Blue]

Put on a pot of coffee. I suspect you will be waiting a long time.

lol...I actually made some tea...

 

[commentator]

"The trial" is not likely to happen. If it were to, if this person were to be prosecuted for Medicaid fraud, I suspect it'd be far far far in the future. And there is about zero chance that it would happen based on what we are being told here from the sound of it. And zero chance that they'll do it based on and with the intimate assistance and support of this person who's at this moment trying to turn her in for Medicaid fraud. All his allegations are being presented without his really understanding what she's is actually reporting or doing or receiving or exactly how the program works. Nothing is criminal fraud until the DA decides it is, after the agency has investigated it. The agency will take his information, and that will be the last he hears of it. Once you've reported what you believe to be fraud, your civic responsibility is over.

And the likelihood that this person was charged with and criminally prosecuted for unemployment fraud thirteen years ago is very very small too, though as this person says the wife committed unemployment fraud back then. If she did, and was found out, the agency investigated and more than likely they either sanctioned her or gave her a waiver or a repayment plan, and either way the matter was dealt with then. If so, there will be no criminal record anywhere, it would just be something he says happened.

 

[quincy]

While what you say is possibly true, stephensel wishes to have his ex-wife criminally charged. The way to do that is to report the suspected fraud to the appropriate authority and there will be an investigation.

From there, it is out of his hands.

 

[LdiJ]

Both known fraud and suspected fraud can (and should) be reported to authorities and investigated. You don't "look bad" for making reports to authorities of crimes you suspect may have been committed.

stephensel doesn't know enough to say definitively that his wife has committed Medicaid fraud and we CERTAINLY don't know enough to say definitively that there has or hasn't been Medicaid fraud.

Yes, but everyone jumped on the Medicaid fraud bandwagon from the very first post, when the odds are really against her committing any kind of Medicaid fraud. Most Medicaid fraud comes from people not reporting changes to income and/or circumstances after they initially qualify for Medicaid.

 

[quincy]

Yes, but everyone jumped on the Medicaid fraud bandwagon from the very first post, when the odds are really against her committing any kind of Medicaid fraud. Most Medicaid fraud comes from people not reporting changes to income and/or circumstances after they initially qualify for Medicaid.

No one "jumped" on any Medicaid fraud bandwagon. The question was about Medicaid fraud.

The first link I provided defines Medicaid fraud. Where are you getting this bandwagon bit?

Where do you get the odds of which you speak? There is absolutely no way to give any sort of odds based on what has been related.

Where are you getting the "most Medicaid fraud comes from ..." information?

Please support the facts you are tossing around. Thank you.

 

[LdiJ]

No one "jumped" on any Medicaid fraud bandwagon. The question was about Medicaid fraud.

The first link I provided defines Medicaid fraud. Where are you getting this bandwagon bit?

Where do you get the odds of which you speak? There is absolutely no way to give any sort of odds based on what has been related.

Where are you getting the "most Medicaid fraud comes from ..." information?

Please support the facts you are tossing around. Thank you.

You assumed that the first post was about Medicaid fraud. In fact, no where in the post did it ask about Medicaid fraud. I interpreted the original post to indicate that it was about the OP believing that she had committed fraud against him, not against Medicaid.

 

[LdiJ]

No one "jumped" on any Medicaid fraud bandwagon. The question was about Medicaid fraud.

The first link I provided defines Medicaid fraud. Where are you getting this bandwagon bit?

Where do you get the odds of which you speak? There is absolutely no way to give any sort of odds based on what has been related.

Where are you getting the "most Medicaid fraud comes from ..." information?

Please support the facts you are tossing around. Thank you.

The information about most Medicaid fraud coming from people not reporting changes once they have qualified comes directly from the mouth of a social services caseworker who is a client of mine. Its not particularly easy to qualify for Medicaid in the first place. It takes a ton of documentation to prove that you qualify (I know that because I was on Medicaid for a short period of time). Therefore its difficult to initially obtain Medicaid fraudulently.

 

[quincy]

You assumed that the first post was about Medicaid fraud. In fact, no where in the post did it ask about Medicaid fraud. I interpreted the original post to indicate that it was about the OP believing that she had committed fraud against him, not against Medicaid.

I assume you read the rest of the thread like the rest of us did?

Where is the support for your previous statements? Something that is not from an unknown someone who once told you something. That is NOT support. That is a story like all of your other stories you tell that conveniently cannot be verified.

Seriously, LdiJ, you have got to do better than this.

 

[LdiJ]

There is a debit card - at least, that is what Georgia's health plans call it.

https://dch.georgia.gov/sites/dch.georgia.gov/files/related_files/site_page/Final Version 2017 CMO Comparison Chart.pdf

Doing just a little bit of research before posting can help you eliminate some of the misinformation you post. Thanks.

And you might want to read what you research just a little more carefully before you criticize what others have said. The Medicaid card itself is NOT a debit card, it is an ID card. Some of the programs on that page DO offer a debit card for some over the counter medical purchases and purchases of things other than medical expenses, like school supplies. Therefore those programs are not strictly Medicaid.