Report Fraud, Waste, and Abuse
Health care fraud, waste, and abuse hurts everyone including members, providers, taxpayers and CareSource. As a result, CareSource has a comprehensive fraud, waste, and abuse program in our Special Investigations Department. Help us by reporting questionable situations.
Examples of member fraud, waste, and/or abuse include:
- Sharing ID cards with others.
- Selling prescription drugs or other prescribed equipment to others to make money.
- Changing prescription forms to get more than the amount of medication prescribed by their physician..
Please report any member fraud, waste, and/or abuse. See the contact information below.
Examples of provider fraud, waste, and abuse include:
- Billing for services not provided.
- Billing for unnecessary medical services.
- Up-coding services to receive higher reimbursement..
- Prescribing drugs or services that aren’t medically necessary.
- Unbundling CPT codes to obtain higher reimbursement.
- Schedule more frequent return visits than are needed.
- Balance billing members for services paid at the Medicaid rate.
Please avoid these examples of provider fraud, waste, and/or abuse. We routinely monitor our claim data looking for billing aberrancies. When found an investigation is initiated and if warranted based on investigative findings, a corrective action is take. Corrective actions can include provider education, termination, legal action, overpayment recovery, etc. If you know of or become aware of provider fraud, waste, and abuse, please let us know using the contact information below.
You can report fraud, waste, and abuse to CareSource by:
- Calling 1-800-390-7102 and selecting the appropriate menu option .
- Sending an e-mail to fraud@csmg-online.com
- Faxing: 1-800-418-0248.
- Writing a letter to :
CareSource
You may also report fraud directly to the Michigan Department of Community Health (MDCH) by:
- Calling 1-866-428-0005.
- Writing :
Medicaid Integrity Program Section
Capitol Commons Center Building
400 S. Pine, 6th Floor
Lansing, MI 48909
When you report fraud, waste, or abuse, please give as many details as you can, including names and phone numbers. You may remain anonymous, but if you do we will not be able to call you back for more information. Your report will be kept confidential to the extent permitted by law.
Under the Deficit Reduction Act of 2005, CareSource is also required to provide information about the federal False Claims Act, state False Claims Acts, and other state laws regarding Medicaid fraud. See our False Claims Act section of this website for more information.
Thank you for helping CareSource keep fraud, waste and abuse out of health care.