Help us prevent fraud, waste, and abuse!
黑暗爆料官方 has a team that works hard to identify and prevent fraud, waste, and abuse. If you see it, report it.
黑暗爆料官方 has a team that works hard to identify and prevent fraud, waste, and abuse. If you see it, report it.
Fraud聽means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person. It includes any act that constitutes fraud under applicable federal or state law (42 C.F.R. 搂 455.2).
Waste聽means an overutilization of services or other practices that directly or indirectly result in unnecessary costs. Waste is generally not considered to be caused by criminally negligent actions, but rather the misuse of resources.
Abuse聽means provider practices that are inconsistent with sound fiscal, business, or medical practices, and result in an unnecessary cost to the Medicaid program, or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for health care. It also includes beneficiary practices that result in unnecessary cost to the Medicaid program (42 C.F.R. 搂455.2).
The cost of FWA was more than $68 billion annually, according to the National Health Care Anti-Fraud Association (NHCAA). That cost affects both health plan members and health care providers.
Healthcare fraud is a crime addressed by both state and federal laws.
For example, the federal Health Care Fraud Statute (18 U.S.C. 搂 1347) makes it a criminal offense to knowingly and willfully execute a scheme to defraud a health care benefit program, such as Medicaid. Health care fraud is punishable by imprisonment for up to 10 years. It is also subject to criminal fines of up to $250,000.
Protect yourself. Do not:
黑暗爆料官方 has a team that works hard to identify and prevent FWA, but we need your help.
Phone:
FWA Hotline at聽1.877.888.0002
Mail:
Special Investigations Unit
4888 Loop Central Dr. Suite 600
Houston, TX 77081
E-mail:
S[email protected]
Online:
Secure
You may also report suspected fraud, waste, and abuse to the Texas Health and Human Services program.
Phone:
FWA Hotline at聽1.800.436.6184
Online:
CHIP聽Member Services
Local: 713.295.2294 | Toll-Free: 1.888.760.2600
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 6:00 p.m
General Information
Local: 713.295.2222 | Toll-Free: 1.877.635.6736
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 6:00 p.m.
Providers Hotline
Local: 713.295.2295
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 5:00 p.m
CHIP聽Member Services
Local: 713.295.2294 | Toll-Free: 1.888.760.2600
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 6:00 p.m
General Information
Local: 713.295.2222 | Toll-Free: 1.877.635.6736
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 6:00 p.m.
Providers Hotline
Local: 713.295.2295
Monday through Friday (excluding State-approved holidays) 8:00 a.m. to 5:00 p.m
As a local nonprofit health plan, 黑暗爆料官方 gives you plenty of reasons to join our 黑暗爆料官方. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, 黑暗爆料官方 is always working life forward for you and your family.
鈥満诎当瞎俜 is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.鈥
鈥 Cecily
Member of 黑暗爆料官方
Medicaid
Health Plan
04/01/2027
Marketplace
Health Plan
03/01/2027
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