Total Health Care has a fraud and abuse program. This program is to make sure health care money is used correctly.
Examples of fraud and abuse by a member include the following:
- Changing information on a prescription, medical record, or referral form.
- Letting someone else use your Total Health Care card to get medical services.
- Using transportation services to do something other than going for medical services.
- "Doctor shopping" for prescriptions.
Examples of fraud and abuse by a provider include the following:
- Billing for more services than were actually performed.
- Giving false information about credentials such as a college degree.
- Billing for services that weren’t done.
- Providing services that are not medically necessary.
If you have any information about fraud and abuse or think that someone may have used your I.D. card, please contact Total Health Care. You can report fraud and abuse anonymously without giving your name by writing or calling:
Total Health Care
Fraud and Abuse
3011 W. Grand Blvd., Suite 1600
Detroit, MI 48202
(313) 871-6591 or toll free (800) 826-2862, ext. 591.
email: results@thc-online.com
You may also report instances of fraud and abuse directly to the Department of Community Health (DCH)/ Medicaid Integrity Program without giving your name. You may call DCH at (866) 428-0005 or send a memo or letter to:
Medicaid Integrity Program Section
Capital Commons Center Bldg, 6th Floor.
400 S. Pine Street, PO Box 30479
Lansing, MI 48909-7979
