Protecting program integrity in Medicaid requires everyone’s assistance. Clients, providers, insurers and government agencies must all work together to protect the state’s health care resources.
Currently, Medicaid and the Children’s Health Insurance Plan (CHIP) provide comprehensive medical coverage to more than four million Texans. When providers or clients defraud the program, it can result in a loss of access to benefits and services for all Medicaid beneficiaries as the state works to balance the health and human services budget against unexpected losses.
Medicaid clients
Medicaid and CHIP are in place to help Texans in need. Unfortunately, some attempt to receive services they do not qualify for or profit from the program. These illegal actions not only lead to costly repayments of benefits when the client is caught but can result in criminal charges.