People with Disabilities

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PCA fraud

  • What is Medicaid fraud?

    Medicaid fraud is when a person obtains, attempts to obtain or helps another obtain assistance benefits to which the person is not entitled by giving false statements, false representations or by withholding information. For example:

    • If you provide false information to the PCA assessor to obtain PCA services you don’t need, that is fraud.
    • If you sign a time sheet that states a PCA worked 30 hours when he/she only worked 20 hours, that is fraud.

    You or your PCA could be held legally responsible for Medicaid fraud. In Minnesota the “theft of public funds” is a felony, no matter the dollar amount. Possible penalties and consequences include:

    • Affected immigration status
    • Affected applications for other jobs
    • Disqualification from working in a Medicaid/Medicare-funded job for five years
    • Disqualification from Section VIII housing
    • Jail time
    • Repayment of money

    Recipients/responsible parties verify PCA hours and request payment by signing PCA time sheets.

    • Recipients/responsible parties must sign PCA time sheets
    • Do not sign blank time cards
    • Only sign timecards for time that PCAs have worked
    • PCAs cannot be paid when they are traveling to and from your house or if they are “on call” by phone or pager 
    • PCAs cannot not get paid for time they are not with you
  • Where can I report suspected fraud?
    • Minnesota Department of Human Services fraud hotlines
    • Minnesota Office of the Attorney General, Medicaid Fraud Control Unit 
    • Minnesota local county attorney’s office
    • Health plan care coordinator
  • Where is more information available?

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