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?

Buckeye Special Investigations Unit (SIU):

• 1-866-685-8664
• special_investigations_unit@centene.com

Ohio Department of Medicaid (ODM):

• 1-614-466-0722

Ohio Auditor Of State (AOS)

• 1-866-FRAUD-OH (866-372-8364)
• fraudohio@ohioauditor.gov

Ohio Department of Job and Family Services

(614) 752-3222

To report Medicare fraud:

U.S. Department of Health and Human Services, Office of the Inspector General

(800) 447-8477

To report private insurance fraud:

Ohio Department of Insurance

(614) 686-1527Report potential fraud:

Office of the Attorney General

• 1-800-282-0515

CMS Fraud, Waste & Abuse Training