Detection, prevention and elimination of fraud, abuse and overuse of services are essential to maintaining a health care system that is affordable to everyone. Although fraud was not specifically mentioned as one of the main cost drivers, it does contribute to higher costs.
Fraud can constitute many things. In its simplest form, it means receiving payment for services that were never received or given. It can also be as simple as including an ineligible family member on insurance coverage.
We are committed to eliminating all fraudulent activity through prevention and awareness. We actively cooperate with criminal investigations conducted by federal, state and local authorities. Our special investigations unit accepts confidential and anonymous tips of possible fraud. Each accusation is thoroughly investigated, and we seek legal intervention if a crime as been committed. We also demand repayment if the situation warrants.
For more information about what constitutes fraud and how you can report a suspected case, see the contact us of this site.
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