Report Fraud and Abuse

As a member of MedStar Family Choice, it is your responsibility to report fraud and abuse. Medicaid defines fraud as an intentional deception made by a person or company with the intent to gain some unauthorized benefit from the deception.

Medicaid defines abuse as practices that do not follow good financial, business or medical practice and result in unnecessary costs or do not meet a standard of care. Fraud and abuse could be committed by the provider, the member or even the MCO. Some common examples of fraud and abuse are:

• Billing for a service that was never performed
• Performing unnecessary procedures
• Altering or forging a prescription
• Allowing others to use a member's ID card for care

While MedStar Family Choice monitors for possible fraud and abuse activities, we need your help to eliminate fraud and abuse. MedStar Family Choice has a strict non-retaliation policy. You don't have to worry about anyone denying you service, removing you from the managed care organization or treating you in any way that would cause you or a family member from feeling that you did something wrong for reporting any incident. If you know of a situation that may involve fraud and abuse, please report it immediately by calling our Compliance Director at (410) 933-3013 or you may call Member Services at (888) 404-3549. Your report will remain confidential.