Report Fraud, Waste and Abuse
Understanding the terms:
- 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:
- Fraud and Abuse Hotline: 1-866-685-8664
- Care1st Attn: Compliance Officer
1850 W. Rio Salado Parkway, Suite 211
Tempe, AZ 85281
- Email: AZFWA@Centene.com
Medicare Fraud Hotline of the HHS office Inspector General
HHSC/OIG Inspector General
Contact Arizona Medicaid (AHCCCS)
- Mail: Office of Inspector General (OIG)
801 E. Jefferson St.,
Mail Drop 4500
Phoenix, AZ, 85034
- To Report Provider Fraud:
- In Maricopa County: 1-602-417-4045
- Outside of Maricopa County: 888-ITS-NOT-OK or 1-888-487-6686
- To Report Member Fraud:
In addition to notifying these regulators, providers must immediately notify Care1st of all suspected fraud, waste, and/or program abuse.
Care1st providers must report suspected fraud, waste, and program abuse directly to the health plan immediately upon identification and notification to their regulator(s).
To protect the public from consumer fraud.
If you believe you have been the victim of consumer fraud, you may file a consumer complaint with the Arizona Attorney General's Office. For consumer inquiries, or to request a complaint form, call (602) 542-5763 (Phoenix), (520) 628-6648 (Tucson), or toll-free outside of metro Phoenix, (800) 352-8431.