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://forms.oig.hhs.gov/hotlineoperations/
Tribute Health Plan of Arkansas HMO SNP: (866) 583-4649
http://www.stopmedicarefraud.gov/
(Please note: By clicking on this link you will be leaving the Tribute Health Plan website.)