What is Fraud, Waste and Abuse?
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).
The over-utilization of services or other practices that result in unnecessary costs.
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
Valor Health Plans: (877) 372-1033
Online: Medicare.gov Fraud Reporting Information