Preventing and Reducing Fraud and Abuse

Fraud and abuse are against the law and may result in criminal penalties. Maryland Physicians Care encourages reporting of suspicious activities. You can report fraud and abuse without the fear of retaliation. All suspected incidences of fraud and/or abuse are reported to the Maryland Department of Health, Office of Inspector General for further investigation. Examples of fraud and abuse include:

Someone using an ID card that does not belong to them.
Providers billing for services or supplies that were not provided.
Providers giving too many tests and services or unneeded tests and services.
Selling prescription medications or making changes to a written prescription.
Falsely reporting household income.
Not living in Maryland but receiving Maryland Medicaid.

You do not need to give us your name or contact information to report fraud and abuse, but we will keep it private if you do. It is important that you give us as much information as you can because it will help us do a complete and correct investigation.

To report fraud and abuse, you can:

CALL MPC’s Compliance Hotline at 1-866-781-6403 and leave a detailed message.
WRITE to the Compliance Officer at MPC: 1201 Winterson Road, 4th Floor, Linthicum Heights, MD 21090.
Complete the ONLINE Fraud and Abuse Form below.

Fraud and Abuse Reporting Form

Please use this form to report suspected fraud or abuse of services paid for by Maryland Physicians Care. Please complete as much of the requested information as you can below.

I suspect (name below) of fraud or abuse*
This person's address*
Street Address City State ZIP Code
What is the phone number?
Are you a doctor or health care facility?*
- Yes
- No
What is the name of the doctor's practice or health care facility?
Please tell us why you suspect this person of wrong doing. For example, what the person did, when it happened, etc.*
Optional Information
You don’t need to give us your name or contact information. But if you do, we’ll keep it confidential. You can also choose to give us just your contact information and not your name.
If you choose not to give your contact information, our review will be only about the information you’re reporting. It’s important that you give us as much information as you can. It will help us do a complete and correct investigation.
Person Reporting
First Last
Address
Street Address City State ZIP Code
Phone Number
Email Address
Phone
This field is for validation purposes and should be left unchanged.

Preventing and Reducing Fraud and Abuse

Fraud and Abuse Reporting Form

Optional Information