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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
Valor Health Plans: (844) 223-2371
Online: Medicare.gov Fraud Reporting Information

Last Updated: Sep 12, 2019 @ 7:38 pm

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