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
Not telling Aetna Assure Premier Plus (HMO D-SNP) that you have other insurance
Examples of provider fraud, waste and abuse include:
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
If you suspect fraud, waste or abuse related to your coverage, you can:
You can call our Fraud, Waste and Abuse Hotline at 1‑855‑282‑8272 (TTY: 711).
You can report suspected cases of fraud, waste and abuse to the state of New Jersey at 1-888-937-2835 or 1-888-692-2140.
Aetna Assure Premier Plus (HMO D-SNP) is not responsible or liable for content, accuracy or privacy practices of linked sites or for products or services described on these sites. If you did not intend to leave our site, click or tap the "x" in the upper right-hand corner.
This link will take you to the main Aetna® Medicaid website (AetnaBetterHealth.com). Aetna Assure Premier Plus (HMO D-SNP) is not responsible or liable for this specific content.
This link will take you to the Aetna Assure Premier Plus (HMO D-SNP) provider website. It contains information for health care professionals. If you don't want to leave the member site, click or tap the "x" in the upper right-hand corner.
