An official website of the State of North Dakota
Language: English
The State of North Dakota provides automatic translation for nd.gov websites, courtesy of Google Translate. Please remember, though, that the English language version is considered the most accurate. In the event of a disagreement or discrepancy between the translation and the original English version of this web site or any notice or disclaimer, the original version will prevail.
The North Dakota Department of Human Services mission is to provide quality, efficient, and effective human services, which improve the lives of people.
Medicaid and the Children’s Health Insurance Program (CHIP) provide healthcare coverage to qualifying low-income, disabled individuals and children, and families. Fraud can be committed by Medicaid providers or recipients. The Department does not tolerate misspent or wasted resources.
By enforcing fraud and abuse efforts:
If a provider on the ND Medicaid Provider Exclusion list is a Qualified Services Provider (QSP), they will not have a National Provider ID number. North Dakota can verify QSP providers by name, date of birth, and last four of their social security number.
ND Medicaid Provider Exclusion List – Includes Qualified Service Providers (12-6-22) PDF
ND Medicaid Provider Exclusion List – Includes Qualified Service Providers (12-6-22) Excel
Searchable National Provider ID Registry
To report suspected Medicaid Fraud, please email medicaidfraud@nd.gov, or call 1 (800) 755-2604 and ask for an attendant. You may also complete the Surveillance and Utilization Review Section (SURS) Referral form and submit it to the Department.
Email all inquiries to medicaidfraud@nd.gov.
Fraud Alert:
U.S. Department of Health and Human Services Office of Inspector General hotline telephone number used in scam (Posted March 6, 2017)
Fraud is an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to them or some other person.
Abuse is when provider practices are inconsistent with sound fiscal, business, or medical practices that result in an unnecessary cost to the Medicaid program, or in reimbursement for services that are not medically necessary or services that fail to meet professionally recognized standards for healthcare. Abuse may also include recipient practices that result in unnecessary costs to the Medicaid and CHIP programs.
Provider: committed by the practitioner, health facility, or other entity that provides services to Medicaid recipients.
Examples:
Recipient: committed by a Medicaid or CHIP recipient
Examples:
REPORT any instance of suspected fraud or abuse.
What is my role as a Medicaid recipient in preventing fraud and abuse?
Complete the Surveillance and Utilization Review Section (SURS) Referral (SFN 20) form
Phone: (701) 328-4024
Toll-Free: 1 (800) 755-2604
Email: medicaidfraud@nd.gov
Fraud, Waste and Abuse Administrator
c/o Medical Services Division
600 E Boulevard Ave Dept 325
Bismarck ND 58505-0250
Fax: (701) 328-1544
Visit website: Office of Inspector General – US Department of Health and Human Services
Visit website: Centers for Medicare & Medicaid Services
Copyright 2022 North Dakota Department of Health and Human Services
600 East Boulevard Ave Bismarck, ND 58505-0250
Phone: (701) 328-2310
TTY users may use relay North Dakota at 711 or 1-800-366-6888
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