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Fraud, waste and abuse 

Aetna Better Health® of Florida is committed to stopping fraud, waste and abuse. We look to our members and providers to help. So, if you see fraud, waste or abuse, report it right away.

What are fraud, waste and abuse?

Fraud, waste and abuse are dishonest actions by providers or members.

  • Fraud is when someone lies to get money or services.
  • Waste is when someone gets benefits or services (for themselves or others) that they don’t need.
  • Abuse is when someone takes money for services when they shouldn’t.

Provider fraud, waste and abuse

This includes: 


  • Making false medical records 

  • Prescribing more medication than is medically necessary

  • Billing for professional services when a medical professional didn’t perform the service

  • Giving services that members don’t need

  • Billing for services or items they didn’t give

  • Abusing members verbally, physically, mentally or sexually

Member fraud, waste and abuse 

This  includes: 


  • Lending, selling or giving a health plan ID card to someone else  

  • Getting medicines or services you don’t need 

  • Forging or changing prescriptions from providers

  • Getting similar treatments from different doctors 

  • Going to an emergency room if you know it’s not an emergency 

  • Using someone else’s Social Security number or member ID number

  • Receiving money or gifts in exchange for having medical services 

How you can help


Our goal is to cut down on fraud in health care. Here are some ways you can help us:


  • Be careful where you give out your health care info. This includes info like your member ID number. 

  • Watch out for “free” medical care offers. Especially if they ask for your personal health care info.

  • We get bills from your providers to pay. They could be for doctor visits or other services and supplies. Sometimes you’ll get a letter telling you how we paid for these services and asking you some questions. If you do, be sure to fill it out and return it as soon as possible. Know your benefit plan and what types of treatments, drugs, services and supplies are covered.

Report fraud, waste or abuse

Report fraud, waste or abuse

To prevent, report or stop fraud, waste and abuse, you can:



Or call Member Services: 



You have the choice to give your name and info when you make a report. If you do, just know that we keep any info you share with us private.

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