General Definitions

Fraud is defined as acquisition or attempted acquisition, or aiding and abetting acquisition or attempted, of property, income, rights or legal privilege by means of willful false statement, false representative or impersonation, or by any scheme contrived to misrepresent true circumstances.

Welfare fraud involves a willful misstatement or omission of information or act by: vendors or providers of social services; volunteers; other department personnel; or clients, any officer or employee of any county, city or district Michigan Department of Human Services acting alone or in collusion with others, that would cause money, benefits, or services to be paid and/or rendered ineligible.

A welfare fraud complaint should be submitted only if you believe an individual or a business has been issued benefits they were not entitled to in Michigan. A fraud complaint may also be filed against any Michigan Department of Health and Human Services (DHHS) employee suspected of fraud relating to the administration of programs managed by the State of Michigan, DHHS. There are specific fields on each form that must be completed in order for the complaint to be valid, these fields will contain an asterisk (*).

Medicaid fraud is the intentional providing of false information to get Medicaid to pay for medical care or services.

There are many types of Medicaid Fraud. Medical identity theft is one type, it involves using another person’s medical card or information to get health care goods, services, or funds.