What should I do if I receive a letter notifying me of a “credible allegation of fraud”?
If you receive a letter notifying you that your Medicaid provider agreement has been suspended based upon a credible allegation of fraud, you will be prohibited from arranging for, rendering, or ordering services for Medicaid patients during the period of suspension.
Even if you do not treat a lot of Medicaid patients, or any at all, a Medicaid suspension will pose major problems. Other insurance carriers such as private payers or Medicare may take adverse action against you. The suspension may have to be reported to licensing boards. A related investigation by the Ohio Attorney General or other law enforcement will likely be underway, or will be soon. There is also a small window for requesting reconsideration of the suspension, so you need to act quickly.
Contact an experienced health care fraud attorney as quickly as possible.