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Member and Provider Inquiries: 800-405-9681 (TTY 711)

PPHP is Committed to Your Good Health

What is Fraud, Waste and Abuse?

Fraud: Intentional deception or misrepresentation to obtain the money or property of a health care benefit program (by means of false or fraudulent pretenses, representations, or promises).

Waste: The over-utilization of services or other practices that result in unnecessary costs.

Abuse: Obtaining payment for items or services when there is no legal entitlement to that payment, but without knowing and/or intentional misrepresentation of facts to obtain payments.

What can you do to help prevent, report, and stop Fraud, Waste, and Abuse?

Report potential fraud:

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Page Last Updated:  5/19/2019

Provider Partners Illinois Advantage is an HMO-SNP with a Medicare contract. Enrollment in Provider Partners Illinois Advantage depends on contract renewal. H3800_PPHPWEB_2020

Provider Partners Maryland Advantage is an HMO-SNP with a Medicare contract. Enrollment in Provider Partners Maryland Advantage depends on contract renewal. H8067_PPHPWEB_2020

Provider Partners Health Plans of Ohio is an HMO-SNP with a Medicare contract. Enrollment in Provider Partners Health Plans of Ohio depends on contract renewal. H7119_PPHPWEB_2020

Provider Partners Pennsylvania Advantage is an HMO-SNP with a Medicare contract. Enrollment in Provider Partners Pennsylvania Advantage depends on contract renewal. H4093_PPHPWEB_2020