Help fight health care fraud and abuse

Health care fraud and abuse increases costs for everyone.

Fraud and abuse can also make you sick and even hurt you. That’s why it’s important for you to learn more about it. Examples of health care fraud include:

• A doctor bills for something that he or she didn’t do in order to be paid by a health plan.
• A person receives health care services under someone else’s name.
• A doctor sells an unproven cure for a medical condition which could lead to more health problems. These are often called “cure-alls” or “miracle cures.”

Examples of health care abuse include:

• A person goes to different doctors just to get more prescription medication.
• A person goes to the emergency room for non-emergency medical services.
• A doctor makes a mistake and bills for services under the wrong patient.

Visit priorityhealth.com to learn more about fraud and abuse.

Protect yourself and your family

1. Treat your Priority Health Medicaid and Social Security numbers like credit card numbers. Don’t share them with others.
2. Rip up your Priority Health Medicaid papers and any other papers with important personal information before throwing them away.
3. Don't keep mail in your mailbox for more than one day. People steal personal information right out of your mailbox.
4. Do your homework and talk to your doctor before buying “cure-alls” or “miracle cure” products or services.
5. Remember Priority Health Medicaid doesn’t sell anything.
6. Follow your feelings — if it seems too good to be true, it usually is.

Reporting fraud and abuse

If you think you know about health care fraud or abuse, contact Priority Health right away. You don’t have to give your name, address or phone number.

• Call Customer Service at 616 942-1221 or 800 446-5674.
• Call the compliance helpline at 800 560-7013 (available 24 hours a day).
• Write to:
  Priority Health Fraud and Abuse Program
  Finance Department — Mail Stop 2305
  1231 East Beltline NE
  Grand Rapids, MI 49525-4501

You can also contact the State of Michigan Medicaid department directly about fraud or abuse. You don’t have to give your name, address or phone number.

• Call toll-free 866 428-0005.
• On the Internet, go to michigan.gov/mdch. Follow the instructions provided.
• You can also write to:
  Program Investigation Section
  Capitol Commons Center Building
  400 South Pine, 6th Floor
  Lansing, MI 48909

Topics: Health care costs