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Effective: December 1, 2006 |
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29.10ar1 - Fraud (Archive) |
Archived: December 1, 2008 |
This section covers the definition of fraud, referrals for investigation, and how fraud affects eligibility. Administrative Disqualification Hearings covers specific provisions related to administrative disqualification for GAMC and MinnesotaCare adults without children.
MinnesotaCare Adults Without Children and GAMC.
Fraud exists when any of the following occur:
l People willfully or intentionally withhold, conceal or misrepresent information to receive or attempt to receive coverage that they are not eligible for.
l People plan with or knowingly help another person to fraudulently seek or obtain assistance.
Refer anyone you suspect of fraud for investigation.
l County agencies should refer cases to the county’s fraud investigators.
l MinnesotaCare Operations should refer cases to the DHS Program Integrity and Assessment Division (PAID).
Clients are not eligible for TMA or TYMA if convicted of MA fraud in:
l Any of the six months before termination of regular MA.
l Any month of TMA or TYMA eligibility.
Remove caretakers who are convicted of fraud. The children may remain on TMA or TYMA.
MinnesotaCare Adults Without Children and GAMC
Clients are not eligible during a period of Fraud Disqualification.
For GAMC only, people who are convicted of making fraudulent statements about residence to receive duplicate assistance from two or more states are ineligible for 10 years.
More general fraud information can be found on the DHS website, including how the public can report suspected fraud.