Fraud, Waste & Abuse

FRAUD ALERT: Beware of Phone Scams

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently confirmed that the HHS OIG Hotline telephone number is being used as part of a telephone spoofing scam.

Reporting concerns

MedicareBlue Rx takes allegations of Medicare fraud and abuse very seriously. If you think that you or a MedicareBlue Rx member has been a victim of Medicare or health insurance fraud or abuse, please call 1-866-311-4216 (TTY hearing impaired users call 711)

Medicare contact information:

You may also contact Medicare directly with concerns about Medicare Advantage plans or Medicare Prescription Drug Plans, such as MedicareBlue Rx, at:

  • 1-800-MEDICARE (1-800-633-4227) 24 hours per day, seven days a week
  • TTY hearing impaired users call 1-877-486-2048

About Waste 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 and abuse. That means there is less money to help people like you who depend on these programs for health care. MedicareBlue Rx is actively working to identify, investigate, and prosecute health insurance fraud, but we need your help.

Some examples of fraud:

  • 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

Some examples of abuse:

  • Billing too much for services or supplies
  • Claims for services that aren’t medically necessary
  • Improper billing practices

Visit Medicare.gov for more information about Medicare fraud and abuse.

Confidentiality

Every effort will be made to protect the identity of the reporting party. There will be no retaliation for good faith reporting.