Help Fight Fraud, Waste and Abuse

Medicaid pays doctors, hospitals, pharmacies, clinics and other health care providers to take care of adults and children who need help getting medical care. Sometimes, providers and patients misuse Medicaid resources. This leaves less money to help people in our state who need care. This misuse is called fraud, waste and abuse.

What are fraud, waste and abuse?

Why should I care about fraud, waste and abuse?

Fraud, waste and abuse affects members and providers. It can:

  • Raise your taxes
  • Keep providers from being paid for services
  • Lead to rising costs

Fraud is a real crime that can lead to fines or even jail time.

What to look for

Blue Cross Complete of Michigan works to find, investigate and stop fraud. Know what to look for. When you get a bill from your doctor or an Explanation of Benefit statement, make sure:

  • The name of the doctor is the same doctor who treated you
  • The type and date of service are the same type and date of service you received
  • The diagnosis is the same as what your doctor told you

Cutting down on fraud, waste and abuse helps Michigan provide more care and makes the Medicaid program even stronger. Together we can stop fraud.

Tell us about fraud

When you report fraud, waste or abuse, you don't have to leave your name. To make a report, write:

 

Blue Cross Complete Anti-fraud Unit
P.O. Box 018
Essington, PA 19029

You may also report or get more information about fraud from the Michigan Department of Health and Human Services Office of Inspector General.

 

Michigan Department of Health and Human Services Office of Inspector General
P.O. Box 30062
Lansing, MI 48909

When you report fraud to the Office of Inspector General, you don’t have to leave your name. Information may be sent or left anonymously.

Note: Information you share over e-mail is not secure and could be read by a third party. If you are sending information you want to keep private, contact us by telephone, fax or letter.

More Information

For more information about health care fraud, contact the following organizations:

National Health Care Anti-Fraud Association
Phone: 1-202-659-5955
Email: fraud@nhcaa.org

Centers for Medicare and Medicaid Services
Phone: 1-877-267-2323

Michigan Department of Health and Human Services
Phone: 1-517-373-3740