PROVIDER PARTNERS HEALTH PLANS 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:
The Provider Partners Health Plans Compliance Hotline 1-833-213-0636 is available 24 hours a day/7 days per week to our employees, members, providers and FDRs. The hotline allows for anonymous reporting of potential non-compliance and FWA matters. We also maintain a Compliance email address: compliance@pphealthplan.com.
- Medicare Fraud Hotline of the HHS office Inspector General: (800) 447-8477
- HHSC/OIG Inspector General: (800) 436-6184
- Web: https://oig.hhs.gov/
- Provider Partners Health Plans HMO SNP: (833) 213-0636
- https://www.medicare.gov/forms-help-resources/help-fight-medicare-fraud/how-report-medicare-fraud
Page Last Updated: 5/23/2023