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:
Contact Arizona Complete Health
- Fraud and Abuse Hotline: 1-866-685-8664
- Arizona Complete Health Attn: Compliance Officer
1870 W. Rio Salado Parkway
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 the regulators above, providers must immediately notify Arizona Complete Health of all suspected fraud, waste, and/or program abuse. Arizona Complete Health providers must report suspected fraud, waste, and program abuse directly to the health plan immediately upon identification and notification to their regulator(s).