Fraud means an intentional deception or misrepresentation made by a person who knows that the deception could lead to his or her benefit. Or, it could lead to the benefit of someone else. It includes any act of fraud under federal or state law.

Example of Fraud

Sam’s pharmacy bills Medicaid for a medication that Sam didn't receive. The pharmacy knew Sam did not receive the medication. But, the pharmacy sent a bill for the medication anyway.

This is an example of fraud because the pharmacy intentionally billed for a medication that was not given to the customer.