Fraud Prevention

You can help stop health care fraud!

Health care fraud takes money from health care programs and leaves less money for real medical needs. Here are ways you can help stop fraud:

• Do not give your member identification number to anyone other than a health care provider, a clinic or hospital, and only do so when you receive care.
• Never let anyone borrow your member identification card.
• Never sign a blank insurance form.
• Be careful about giving out your Social Security number.
• Check your mail for medical bills for services you did not receive.

If you think fraud has taken place, please report it right away. Your report will be kept private. When reporting fraud, waste, or abuse, gather as much information as you can.

When reporting a provider (a doctor, dentist, hospital, etc.) provide as much information as you can from the following:

• Name, address and phone number of the provider.
• National Provider Identification number of the provider and location, if possible.
• Type of provider (doctor, dentist, hospital, pharmacy, etc.).
• Names and phone numbers of witnesses who can help with the investigation.
• Dates when you suspect the fraud happened.
• A summary of what happened.

When reporting a client (a person who receives benefits), provide the following:

• The person’s name.
• The person’s date of birth or social security number.
• The city where the person lives.
• Details about the fraud or abuse.

You can report fraud without giving us your name by sending a letter to: 

Attn: Director of Corporate Compliance
Children’s Community Health Plan
PO Box 1997, MS 6280
Milwaukee, WI 53201-1997

Local: 414-266-2215
Toll-free 1-877-659-5200

You can also contact Wisconsin’s Medicaid Fraud Unit  through a form: 

Report fraud in the State of Wisconsin

or by mail:

Medicaid Fraud and Abuse Unit
Contact: Medicaid Fraud Control Unit
Department of Justice
17 W. Main Street
PO Box 7857
Madison, WI 53707