Fraud & Abuse

Medicaid Fraud & Abuse

CHRISTUS Health Plan has an aggressive, proactive fraud and abuse program that complies with state and federal regulations. We targets areas of health care-related fraud and abuse, including internal fraud, electronic data processing fraud and external fraud.

A Special Investigations Unit (SIU) detects, investigates and reports any suspected or confirmed cases of fraud, abuse or waste to the Office of Inspector General. During the investigation process, the confidentiality of the patient and of people referring the potential fraud or abuse case is maintained.

When reporting about a provider (a doctor, dentist, counselor, etc.), include:

  • Name, address and phone number of provider
  • Name and address of the facility (hospital, nursing home, home health agency, etc.)
  • Medicaid number of the provider and facility (if you have it)
  • Type of provider (doctor, dentist, therapist, pharmacist, etc.)
  • Names and phone numbers of other witnesses who can help in the investigation
  • Dates of events
  • Summary of what happened

When reporting about someone who gets benefits, include:

  • The person’s name
  • The person’s date of birth, Social Security Number or case number (if you have it)
  • The city where the person lives

Please describe the activity that may be fraud or abuse. Some examples are:

  • Billing for services you did not receive
  • Billing for services that were not provided
  • Someone using your identity to receive medical services

Please provide your contact information as well so we can discuss your response with you:

  • Your first and last name
  • Street address
  • Phone number
  • Email address
  • Billing for services that were not provided
  • Someone using your identity to receive medical services

Suspect fraud?

If you suspect a provider or another member is guilty of fraud, abuse or waste, you can report it in one of three ways:


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Last updated: 2/23/17