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Medicaid Fraud and Abuse

Fraud and abuse occur when false or untrue information is given to receive health care benefits, services, and/or payments, either for that person or for someone else. If you suspect a member or a provider has committed fraud, waste, or abuse, you have a responsibility to report it. Examples of member fraud, waste, or abuse include, but are not limited to:

  • Lending your insurance ID card to someone else.
  • Using more than one provider to get similar treatments and/or medications.
  • Frequent emergency room visits for non-emergency conditions.
  • Not living in Maryland.
  • Falsely reporting household income or under-reporting income, insurance, resources and assets, such as bank accounts, stocks, bonds, and property.
  • Altering a written prescription.
  • Selling prescription medications.

To report fraud or abuse, gather as much information as possible. You can report providers or members directly to Kaiser Permanente by writing to:

Compliance Department
Program Integrity
Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
2010 East Jefferson Street
Rockville, MD 20852

You can also contact the Office of Inspector General Hotline at 866-770-7175. Reporting fraud and abuse will not affect how you are treated by Kaiser Permanente.

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