Fraud, waste and abuse

There are many different types of fraud, waste and abuse. Health care fraud affects all of us. It impacts the quality of health care. It also results in higher costs. We want to know if someone is taking advantage of you or our services. If you have any questions about reporting fraud, waste or abuse, you can call Aetna Assure Premier Plus (HMO D-SNP) at 1-855-282-8272 (TTY: 711).

Instances of Fraud, Waste, and Abuse (FWA) can result in significant financial penalties. You may report FWA through the Aetna resources at the bottom of the page. Additionally, you can also report it to the Office of State Comptroller, Medicaid Fraud Division hotline at 1-888-937-2835 or their website.

Member fraud, waste and abuse

Committing fraud, waste or abuse is a crime. You can face serious consequences for committing these acts. You must pay back any money given to you for services. You may be prosecuted for a crime and go to jail. You could also lose your Aetna Assure Premier Plus (HMO D-SNP) coverage for up to a year. Member fraud, waste and abuse can be:

Lying or holding back information when you sign up to be a member of Aetna Assure Premier Plus (HMO D-SNP)
Letting someone else use your Aetna Assure Premier Plus (HMO D-SNP) ID card