Report Insurance Fraud and Abuse
Health care fraud and abuse affects all of us by increasing the cost of health care services and health coverage premiums.
To combat fraud and abuse, Florida Blue’s Special Investigation Unit conducts investigations when a fraudulent insurance act is suspected or has been committed. These acts range from billing for a service that was never rendered to duplicate submission of a claim for the same service and misrepresenting the services provided.
If you believe you have information relating to health care fraud and/or abuse, file an Insurance Fraud and Abuse report. We review all reports and may contact you if additional information is needed. Allegations that show sufficient evidence to support possible fraudulent activity may be assigned for investigation.
Reports can be completed and submitted online, or you may download a form in PDF format and return it to us by U.S. mail. If you are unable to complete one of the forms below, you may call the Special Investigation Unit.
Fraud, Waste and Abuse Training- The Centers for Medicare & Medicaid Services (CMS) has developed training that may be used to satisfy fraud, waste and abuse and general compliance training requirements. To access the CMS Training File:
- Navigate to http://www.cms.gov/Outreach-and-Education/Medicare-learning-Network-MLN/MLNProducts/ProviderCompliance.html
- Go to Fraud and Abuse-related Resources.
- Click on “Medicare Parts C and D Fraud, Waste, and Abuse Training and Medicare Parts C and D General Compliance Training.”
- Follow the instructions for accessing the web-based trainings and downloadable PDF versions.
For More Information
Contact the Florida Blue Special Investigation Unit at
FB FRD 001 NF 102016