Identifying and preventing fraud
Learn to identify and prevent what could be considered fraud by reviewing the rules below.
issue | guidance |
---|---|
Recipient’s functional ability | Recipients cannot lie about their need and providers cannot claim more hours than needed. |
Using a false identity | Providers must use their own personal information, such as name, address, and social security number. A provider must have legal employment status. Using a false identity is a crime under Penal Code §529.5. |
Timesheets | Providers cannot claim more hours than actually worked. This is a crime punishable under Penal Code §72 and §487(a).
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Recipient out of home | A provider cannot be paid if the recipient is out-of-home due to:
IHSS is designed to help the recipient to remain safely in their own home. Therefore, providers cannot claim hours worked while the recipient for is temporarily residing out of the home. If the recipient for is hospitalized or out of their home, providers cannot claim any hours. This includes time for providing translation services, housekeeping, laundry, or preparing and bringing the recipient food. When a recipient returns home, a provider cannot make up hours by adding extra hours to their next timesheet. |
Subcontracting | Providers cannot hire others to do their IHSS duties for them and claim those hours on their own timesheet. Providers must be registered and authorized through IHSS. If they hire unauthorized providers, this is a punishable crime under Penal Code §72. |
Check splitting | A provider cannot submit timesheets and accept payment for work that was not done or split the pay with the recipient for or others. The provider and recipient can be taken to court for theft and submitting a false timesheet under Penal Code §487(a) or Penal Code §72. |
Reported for IHSS fraud?
If someone reports your involvement with fraudulent IHSS activities, an investigation may be conducted. If you are found to be withholding income information to another program, a referral will be sent to the appropriate agency.
Suspect IHSS fraud?
For emergencies, do not contact County of Santa Clara IHSS, please call 911 for immediate assistance.
If you believe someone has engaged in fraudulent activity in the County of Santa Clara, contact one of these offices:
- Call the IHSS Program Integrity Line at (408) 792-1782 or email us at [email protected].
- Call the California Department of Health Care Services Fraud Hotline at (800) 822-6222 or email the DHCS Fraud team at [email protected].
- Submit your complaint through Stop Medi-Cal Fraud.
More about fraud
To learn more about fraud, view our brochures in: