Health care fraud costs you
Health care fraud is costly. Studies show between 3% and 10% of our national
health care spending is lost to fraud. And that adds up to higher doctor's fees
and higher health plan premiums for you.
GEHA is committed to fighting health care fraud and abuse, and to helping you
get the best value for your health care dollars. This information will help you
recognize health care fraud, and offer tips on how to help prevent it.
Remember, health care fraud is a federal criminal offense. If you suspect that a
provider or a consumer is committing health care fraud, you can report the
information to GEHA by email at firstname.lastname@example.org
It is a crime to knowingly provide false or misleading information for the purpose of obtaining financial benefits.
What is not fraud?
What is abuse?
Routine billing issues and delays in payments
Disagreements about claims
What may be fraud?*
Services or treatment not medically necessary
Treatment not consistent with a diagnosis
How to help prevent fraud:
Billing for services not provided
Billing for services by a licensed doctor when services were actually provided
by a non-licensed person
Billing for excessive or unnecessary medical supplies
Billing for medical equipment before delivery or billing for medical equipment
after it has been returned to the vendor
Billing for medical equipment not delivered
Alterations on billings
Review your explanation of benefits carefully to make sure you received the
services indicated. Notify the plan immediately if services were not rendered.
Beware of "free" offers.
Never provide your insurance card to anyone other than the provider of service.
If it sounds too good to be true, pass it up. It's probably not true.
Be careful with providers that refer to alternative treatments or remedies.
How to report suspected health care fraud or abuse:
If you have information you want to share with GEHA, send us an email at
For more information about stopping health care fraud, go to
health care fraud on the Office of Personnel Management website.
*These activities may constitute fraud if they are done intentionally.