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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
- Web: https://oig.hhs.gov/
- Texas Independence Health Plan HMO SNP: (888) 418-1566
- https://www.medicare.gov/basics/reporting-medicare-fraud-and-abuse
