Fraud, Waste and Abuse

Let us know if you think a doctor, dentist, pharmacist at a drug store, other health care provider, or a person getting benefits is doing something wrong. Doing something wrong could be fraud, which is against the law, waste, or abuse. For example, tell us if you think someone is: 

  • Getting paid for services covered by Blue Cross under the Healthy Kids Dental program that weren't given or necessary
  • Not telling the truth about a medical condition to get medical or dental treatment
  • Letting someone else use a Blue Cross Healthy Kids Dental program ID card
  • Using someone else's Healthy Kids Dental ID card
  • Not telling the truth about the amount of money or resources he or she has to get benefits

Report fraud, waste and abuse in the following ways. You can remain anonymous.

call number

Fraud hotline: 1-800-237-9139

Anonymous hotline: 1-866-654-3433

fax

Fax: 262-241-7366

contact by mail

Blue Cross Blue Shield of Michigan
P.O. Box 491
Milwaukee, WI 53201-0491

You can also report fraud, waste or abuse directly to the Michigan Department of Health and Human Services using the following methods:

Michigan Department
of Health and Human Services
Office of Inspector General
               P.O. Box 30062
               Lansing, MI 48909

call

1-855-MIFRAUD (643-7283)

You can also visit MDHHS-OIG@michigan.gov for more information. 

To report fraud, waste or abuse, gather as much information as possible. 

  • When reporting about a provider (doctor, dentist, counselor, etc.) include the name, address and phone number of the provider
    • Name and address of the facility (hospital, nursing home, home health agency, etc.)
    • Medicaid number of the provider and facility, if you have it
    • Type of provider (doctor, dentist, therapist, pharmacist, etc.)
    • Names and phone numbers of other witnesses who can help in the investigation
    • Dates of events
    • Summary of what happened

When reporting about someone who gets benefits, include:

  • The person’s name
  • The person’s date of birth, Social Security number, or case number if you have it
  • The city where the person lives
  • Specific details about the fraud, waste or abuse