GEHA is committed to fighting health care fraud, waste and abuse, and helping you get the best value for your medical care. GEHA partners with local, state and federal agencies to report and investigate health care fraud.
Fraud is generally defined as knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program or to obtain (by means of false or fraudulent pretenses representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program. (18 U.S.C. § 1347) Waste is over-utilization of services or other practices that, directly or indirectly, result in unnecessary costs to the health care system, including the Medicare and Medicaid programs. It is not generally considered to be caused by criminally negligent actions, but by the misuse of resources. Abuse payment for items or services when there is no legal entitlement to that payment and the individual or entity has not knowingly and/or intentionally misrepresented facts to obtain payment.
GEHA works with local, state and federal agencies to report and investigate health care fraud. We encourage our members to report incidents with our partners.
Medicare/Medicaid health care fraud (Office of Inspector General, Department of Health and Human Services)
Federal employee health care fraud (U.S. Office of Personnel Management)
Using U.S. Postal Service for Post Office fraud (U.S. Postal Service Office of Inspector General)
Identity fraud (Federal Trade Commission)
National Health Care Anti-Fraud Association (Public/private partnership for health care fraud)
Don't assume it will not happen to you. GEHA encourages our members to take the following steps:
If you suspect health care fraud or are the victim of identity theft, you can report the incident to GEHA at firstname.lastname@example.org or call us at 800.821.6136. We also encourage you to report incidents to our partners.