Fraud, Waste & Abuse

Fraud, waste and abuse take place as a result of dishonest actions by providers or members. These can be actions taken by providers to receive payments that are not owed, or by members to get benefits (for themselves or for others) that they are not entitled to. The following are some examples of fraud, waste and abuse:

  • Members selling or lending their ID card to someone else
  • Members trying to get drugs or services they don’t need
  • Members forging or altering prescriptions they receive from their providers
  • Providers billing for services they didn’t give
  • Providers giving services members don’t need
  • Verbal, physical, mental, or sexual abuse by providers

Call our fraud, waste and abuse hotline at 1-855-282-8272, TTY 711 to report these types of acts right away. You can do this confidentially. We do not need to know who you are.

You can also report suspected fraud, waste or abuse to the State of New Jersey by calling 1-888-937-2835.

You also report fraud, waste and abuse online.