What is Fraud, Waste and Abuse?
Fraud:
Intentional deception or misrepresentation to obtain the money or property of a health care benefit program (by means of false or fraudulent pretenses, representations, or promises).
Waste:
The over-utilization of services or other practices that result in unnecessary costs.
Abuse:
Obtaining payment for items or services when there is no legal entitlement to that payment, but without knowing and/or intentional misrepresentation of facts to obtain payments.
What can you do to help prevent, report, and stop Fraud, Waste, and Abuse?
Report potential fraud:
Medicare Fraud Hotline of the HHS office Inspector General: (800) 447-8477
HHSC/OIG Inspector General: (800) 436-6184
Dignity Health Plan: (866) 266-6010
Online: Medicare.gov Fraud Reporting Information
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