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May 1, 2012 - April 30, 2013
The vast majority of Medical Assistance (MA) providers and recipients provide and receive care within the boundaries of applicable regulations. Unfortunately, a small number of Medical Assistance recipients and providers engage in practices that are fraudulent or abuse of the Medical Assistance program. Dollars lost to such practices are then unavailable for providing care to those in need. The Department of Public Welfare is committed to eliminating all forms of fraud and abuse within the Medical Assistance program. Your help will enable us accomplish this goal. You can report suspected fraud and abuse by telephone (1-866-DPW-TIPS ), U. S. Mail, or email.
Reported problems will be referred to the appropriate Office of Administration's Bureau of Program Integrity for investigation, analysis, and determination of the appropriate course of action. Examples of fraud and abuse appropriate for reporting are set forth below:
Recipient Fraud and Abuse
Abuse of Recipients
Denial of Services
Review Medical Assistance General Regulations:
View the Pennsylvania Code. Provider prohibited acts are listed at §1101.75. Recipient prohibited acts are listed at §1101.92.