State investigators have accused 15 Alaskans and businesses of filing more than $1.8 million in fraudulent Medicaid claims in five separate cases.
The criminal cases filed in June are part of a broader nationwide effort to crack down on fraud in the jointly funded federal and state program, state officials said.
The defendants include managers and proprietors of Anchorage assisted living homes, a Soldotna dentist and individuals paid by Medicaid for helping to take care of ailing relatives. All were charged with felonies.
The charges go well beyond innocent mistakes and poor record-keeping, said the head of the Alaska Department of Law’s Medicaid Fraud Control Unit, Heather Nobrega.
“Medicaid is not an unlimited amount of money,” she said in an interview. “It’s important for the Medicaid Fraud Unit to figure out who these individuals are who are not abiding by the regulations and are…
Insurance fraud involves making false or exaggerated claims to an insurance provider.
- Hard Fraud: Someone deliberately causes a loss (e.g., setting fire to a warehouse or staging a car accident) specifically to collect a payout.
- Soft Fraud: More common and often viewed as “victimless” by the perpetrator. It involves exaggerating a legitimate claim, such as overstating the value of stolen items in a home burglary to cover the deductible.