Report Fraud, Waste, and Abuse
At SECUR HMO I-SNP, we are committed to safeguarding the integrity of Medicare services by preventing and detecting fraud, waste, and abuse (FWA). Protecting healthcare resources ensures that funds are used appropriately to provide necessary care to our members. If you suspect any fraudulent activities, we encourage you to report it immediately.
What is Healthcare Fraud, Waste, and Abuse?
- Fraud: Fraud occurs when someone deliberately falsifies information or misrepresents facts to obtain unauthorized benefits or payments. Examples include submitting claims for services not provided or altering claims to receive higher payments.
- Waste: Waste refers to the unnecessary use of healthcare services or resources that result in higher costs, often due to inefficiencies or poor practices, but without fraudulent intent. Examples include ordering excessive tests that aren’t needed for treatment.
- Abuse: Abuse happens when healthcare providers or suppliers unintentionally mislead or bill Medicare for services that are not medically necessary, leading to improper payments.
How to Recognize Fraud, Waste, and Abuse?
Common signs of FWA include:
- Receiving bills for services you never received.
- Being asked to provide personal health information for services not related to your care.
- Being offered gifts or incentives for visiting certain healthcare providers or suppliers.
- Providers billing for unnecessary services, equipment, or treatments.
How to Report Fraud, Waste, and Abuse
If you suspect healthcare fraud, waste, or abuse, report it to SECUR HMO I-SNP's Compliance Department immediately. You can do this anonymously, and all reports are taken seriously.
- Phone: Call our Compliance Hotline at 1.833.76SECUR (1.833.767.3287). TTY users can call 711.
- Email: Send an email to [email protected].
- Mail:
SECUR Health Plan
Compliance Department
4200 W. Cypress Street, Suite 690
Tampa, FL 33607
Report Fraud to Medicare
You can also report suspected fraud directly to Medicare:
- Phone: Call 1-800-MEDICARE (1.800.633.4227). TTY users can call 1.877.486.2048. Medicare is available 24 hours a day, seven days a week, except for some federal holidays.
- Online: Visit the Medicare fraud reporting website here.
Why Reporting is Important
Reporting fraud, waste, and abuse is critical to ensuring that Medicare funds are used appropriately to help those who need them most. Fraudulent activities can result in higher healthcare costs and may compromise the quality of care. By reporting suspicious activities, you help maintain the integrity of the Medicare program.
What Happens After You Report?
Once a report is submitted, SECUR HMO I-SNP’s Compliance Team will conduct a thorough investigation. If necessary, we will collaborate with Medicare and other authorities to address any fraudulent, wasteful, or abusive activities.
Protect Yourself from Fraud
Here are steps you can take to protect yourself from healthcare fraud:
- Keep your Medicare card and personal information safe.
- Review your Explanation of Benefits (EOB) statements for any services you did not receive.
- Be cautious of unsolicited requests for your Medicare number or health information.
- Don’t accept offers of free services in exchange for your Medicare number.
Help us maintain a safe and efficient healthcare system by reporting fraud, waste, or abuse. If you have any questions or concerns about potential FWA, please contact our Compliance Department or visit Medicare’s fraud reporting resources.
Find a Provider, Pharmacy or Drug
Search from our database of doctors, hospitals, and other healthcare facilities. You can also find pharmacies or drugs covered by our health plan.
4200 W. Cypress Street, Suite 690, Tampa, FL 33607
Phone: 813.357.5300 | Toll-Free: 1.833.767.3287 (TTY 711)
[email protected]
