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What is fraud, waste and abuse?
- Fraud is when someone lies to get money or services.
- Waste is when someone uses benefits or services they don’t need.
- Abuse is someone taking money for services when they aren’t legally entitled to payment.
Who can I call?
Who can I call?
To prevent, report and stop fraud, waste and abuse, you can call:
- Provider Services: 1-866-600-2139 (TTY: 711)
- Member Services: 1-866-329-4701 (TTY: 711)
- Office of the Inspector General: 1-800-368-1463 (TTY: 1-877-765-3459)
- Illinois Department on Aging's Adult Protective Services Hotline: 1-866-800-1409 (TTY: 1-888-206-1327)
- Illinois Department on Aging's Senior Helpline: 1-800-252-8966 (TTY: 1-888-206-1327)
- Department of Public Health: 1-800-252-4343
- Our fraud, waste and abuse hotline: 1-866-536-0542
Report online
Report online
You can also report fraud, waste and abuse online on the Illinois Department of Healthcare and Family Services (HFS) website. Or you can fill out our fraud, waste and abuse form.
Provider fraud
Provider fraud, waste and abuse includes:
Falsifying medical records
Prescribing more medication than is medically necessary
Giving more health care services than medically necessary
Billing for services that were not rendered
Billing for items not provided
Billing for professional services when a medical professional did not perform the service
Member fraud
Member fraud, waste and abuse includes:
Lending, selling or giving a health plan ID card or HealthChoice Illinois Benefits Identification Card (BIC) to someone else
Getting similar or the same treatments or medicines from more than one provider
Going to an emergency room when it is not an emergency
Using someone else’s Social Security number or health plan ID number
Receiving money or gifts in exchange for having medical services