• Louisiana Employee Medicaid Fraud Form

    For questions, please contact Morning Sun Financial Services at 1-844-450-5444
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  • Louisiana Employee Medicaid Fraud Form

    For questions, please contact Morning Sun Financial Services at 1-844-450-5444

  • Medicaid fraud occurs when a Medicaid provider knowingly makes, or causes to be
    made, a false or misleading statement or representation for use in obtaining
    reimbursement from the medical assistance program. This would include, but is not
    limited to, billing for services not provided, charging Medicaid more than the
    reasonable value of the services and providing services that were medically unnecessary, in order to obtain an improper payment. Medicaid fraud can be a misdemeanor or a felony. If you violate this statute and perform Medicaid fraud you will be prosecuted to the fullest extent of the law. Additionally, if you are convicted of Medicaid fraud, after you complete restitution, which will include penalties which may include a prison sentence and or fine(s), you will be excluded from any employment with a program or facility receiving Medicaid funding. Examples of Medicaid fraud are below. 

  • Signing/submitting a timesheet for services that were not actually provided is Medicaid fraud.*
  • Signing/submitting a timesheet for services provided by a different person is Medicaid fraud.*
  • Signing/submitting a timesheet for services that were reimbursed by another source is Medicaid fraud.*
  • Signing/submitting a duplicate timesheet for reimbursement from the same source is Medicaid fraud.*
  • In order to be employed in this Medicaid program you will be appropriately trained to properly record your time of services, which will require among other measures for you to record your time of arrival to care for your client and your time of departure. You will be trained to record your signature on the employment time sheet, which will also be signed by the client for whom you work.*
  • HIDE- Please type your initials to demonstrate acknowledgement
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  • All suspected cases of Medicaid fraud will be referred to the applicable enforcement office for further investigation and prosecution.

  • Signatures

    I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/

  • I acknowledge that I have read and understand this document.

  • Time of Employee Signature
  • Date of Signature*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date of Signature*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: