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Report Fraud

If you suspect fraud, waste or abuse in the healthcare system, you can report it to Medica HealthCare Special Investigations Unit and we’ll investigate. Your actions may help to improve the healthcare system and reduce costs.

What is Fraud, Waste and Abuse?

Billing for medical services that weren’t ordered or provided
Billing for durable medical equipment items that weren’t ordered or provided
Making sure you do not pay a facility, provider or pharmacy any more than your plan requires. You should also check to be sure that they are only billing for services you received.

To protect yourself from fraud, thoroughly review your Explanation of Benefits (EOB) after you receive healthcare services. If you see something that doesn’t look right, you should report the situation right away.

How to Report Fraud, Waste and Abuse

To report suspected fraud, waste or abuse, you can contact Medica HealthCare Special Investigations Unit at:

Phone:	(800) 455-4521, TTY 711 Tollfree
E-mail:	ReportFraud@UHCSouthFlorida.com
Mail:	P.O. Box 56-6596 Miami, FL 33256

You may remain anonymous and you are protected from retaliation.

Or you may report suspected Medicare fraud directly to the US Department of Health and Human Services, Center for Medicare and Medicaid Services, Office of the Inspector General.

Phone:	(800) 447-8477, TTY (800) 377-4950
Fax:	(800) 223-8164
Online:	oig.hhs.gov/report-fraud
Mail:	Office of the Inspector General US Department of Health and Human Services Attention: HOTLINE PO Box 23489 Washington, DC 20026

Special Investigations Online Referral Form

Briefly describe your concern, including background, persons involved, events, dates and locations.

Name of Person and/or Company you are reporting: (Required)

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The Who, What, Where, When, Why and How of the situation: (Required)

Where did it happen?

When did it happen?

Which category best describes your role: MemberProviderOther

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You may remain anonymous.

The information below is not required, but if you provide it, we will only use it for contacting you if we have any questions.

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