PPHP is Committed to Your Good Health

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:

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Provider Partners Health Plan of Illinois is a Health Plan with a Medicare Contract. Enrollment in Provider Partners of Illinois Health Plan depends on contract renewal.
H8067_002_PPHPWEB CMS Pending

Provider Partners Health Plan of Maryland is a Health Plan with a Medicare Contract. Enrollment in Provider Partners of Maryland Health Plan depends on contract renewal.
H8067_001_PPHPWEB CMS Pending

Provider Partners Health Plan of Ohio is a Health Plan with a Medicare Contract. Enrollment in Provider Partners of Ohio Health Plan depends on contract renewal.
H7119_001_PPHPWEB CMS Pending

Provider Partners Health Plan of Pennsylvania is a Health Plan with a Medicare Contract. Enrollment in Provider Partners of Pennsylvania Health Plan depends on contract renewal.
H4093_001_PPHPWEB CMS Pending

Last updated 11/01/2018

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