Health Care Fraud Division

Patient Rights And Responsibilities In Michigan Licensed Facilities

Partial list as provided by statute, MCLA 333.20201; MSA 14.15(20201)

A patient or resident shall not be denied appropriate care on the basis of race, religion, national origin, sex, age, handicap, marital status, sexual preference, or source of payment.
An individual may obtain or inspect his/her medical records and a third party shall not be given a copy without authorization of the patient except as required by law and third party contract.
A patient or resident is entitled to privacy, to the extent feasible, in treatment and caring for personal needs with consideration, respect, and full recognition of his/her dignity and individuality.
A patient or resident is entitled to adequate and appropriate care and to receive information about his/her-medical condition unless medically contraindicated by the physician in the medical record.
A patient or resident is entitled to receive and examine an explanation of his/her bill. Also, he/she is entitled to know who is responsible for his/her care.
A patient or resident is entitled to associate and have private communication with his/her physician, attorney or any other person, and to receive personal mail unopened, unless medically contraindicated. A patient's or resident's civil and religious liberties shall not be infringed and the facility shall encourage and assist in the exercise of these rights.
A patient or resident is entitled to be free from MENTAL and PHYSICAL ABUSE and from physical and chemical restraints, except those necessitated by an emergency to protect the patient and/or others.
A patient or resident is entitled to retain and use personal clothing and possessions as space permits. At the request of a patient, a nursing home shall provide for safekeeping of personal property, funds, and other property, except that a nursing home shall not be required to provide for the safekeeping of property which would impose an unreasonable burden on the nursing home.
Each patient shall be provided with meals which meet the recommended dietary allowances for the patient's age and sex and may be modified according to special dietary needs.
A health care facility, its owner, administrator, employee, or representative shall not discharge, harass, retaliate or discriminate against a patient because a patient has exercised rights protected by law.
A patient or resident is entitled to adequate and appropriate pain and symptom management as a basic and essential element of his or her medical treatment.

What Does Medicare/Medicaid Fraud Look Like?

Bill for services not provided, i.e. a chest x-ray when an x-ray was not taken;

Duplicate Billing occurs when a provider bills Medicaid and the recipient or private insurance for the same service;

Requires that the patient come back each week for the same problem or to get the same prescription when another appointment is not necessary, or a normal amount of medication could be prescribed;