Fraud, Waste & Abuse

Reporting concerns

Blue MedicareRx (PDP) takes allegations of Medicare fraud and abuse very seriously. If you think that you or a Blue MedicareRx member has been a victim of Medicare or health insurance fraud or abuse, please use the following phone number to report your concern.

Phone:

1-877-853-7693
TTY hearing impaired users call 711
8 a.m. to 8 p.m., daily, local time 

Medicare:

You may also contact Medicare directly with concerns about Medicare Advantage plans or Medicare Prescription Drug Plans, such as Blue MedicareRx, at: 1-800-MEDICARE (1-800-633-4227) 24 hours per day, seven days a week. TTY hearing impaired users call 1-877-486-2048.

About Waste Fraud and Abuse

The U.S. General Accounting Office estimates that $1 out of every $10 spent for Medicare and Medicaid is lost to fraud and abuse. That means that there is less money to help people like you who depend on these programs for health care. Blue Cross Blue Shield of Arizona is actively working to identify, investigate and prosecute health insurance fraud, but we need your help.

Some examples of fraud include:

  • Altering claims to obtain higher payments
  • Soliciting, offering or receiving a kickback, bribe or rebate
  • Using another person's Medicare card to obtain medical care

This is an example of abuse:

  • Claims for prescriptions that aren't medically necessary

Visit Medicare.gov for more information about Medicare fraud and abuse.

Confidentiality

Every effort will be made to protect the identity of the reporting party. There will be no retaliation for good faith reporting.