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Fraud, waste and abuse
Reporting concerns
MedicareBlue takes allegations of Medicare fraud, waste and abuse very seriously. If you think that you have been a victim of Medicare or health insurance fraud or abuse, please use the following phone numbers to report your concern.
For Fraud, Waste and Abuse concerns regarding MedicareBlue Rx (PDP) please contact:
1-888-832-0075 (TTY 1-800-693-3819)
For Fraud, Waste and Abuse concerns regarding MedicareBlue PPO (Regional PPO) please contact:
1-888-457-3009 (TTY 1-888-457-3005)
Medicare:
You may also contact Medicare directly with concerns about Medicare Advantage plans, such as MedicareBlue PPO (Regional PPO), or Medicare Prescription Drug Plans, such as MedicareBlue Rx (PDP), at: 1-800-MEDICARE (1-800-633-4227) 24 hours per day, 7 days a week. TTY users should call 1-877-486-2048.
Examples of Fraud and Abuse
The U.S. General Accounting Office estimates that $1 out of every $10 spent for Medicare and Medicaid is lost to fraud, waste and abuse. That means that there is less money to help people like you who depend on these programs for health care. MedicareBlue is actively working to identify, investigate and prosecute health insurance fraud, but we need your help.
Some examples of fraud include:
- Billing for services or supplies that weren't provided
- Altering claims to obtain higher payments
- Soliciting, offering or receiving a kickback, bribe or rebate
- Health care provider completing Certificates of Medical Necessity (CME) for patients not known to the provider
- Using another person's Medicare card to obtain medical care
These are some examples of abuse:
- Billing too much for services or supplies
- Claims for services that aren't medically necessary
- Improper billing practices
Confidentiality
Every effort will be made to protect the identity of the reporting party. There will be no retaliation for good faith reporting.
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MedicareBlue PPO (Regional PPO)