Fraud, Waste & Abuse
Eliminating fraud, waste, and abuse (FWA) in the delivery of health care is an obligation, responsibility, and legal requirement of all SCAN Health Plan employees, including our contracted providers. This page provides important requirements and expectations in delivering excellence to patients while minimizing risks to yourself and SCAN.
Definitions
- Fraud - intentional misrepresentation that may result in unauthorized costs to the program.
- Abuse - practices that are inconsistent with sound medical or business practices that may directly or indirectly, result in unnecessary costs to the program.
- Waste – the use of health care funds without a real need.
Differences
There are differences between fraud, waste, and abuse. One of the primary differences is intent and knowledge. Fraud requires the person to have an intent to obtain payment and the knowledge that their actions are wrong. Waste and abuse may involve obtaining an improper payment, but does not require the same intent and knowledge.
For More Information
To Report Fraud, Waste or Abuse now
You have several ways to report. The easiest is to submit your report online.
Report Now
Contact the SCAN SIU Team:
- Email: FraudWaste&AbuseProg@scanhealthplan.com (for a PDF of our report form to complete and attach to your email, click here)
- Phone: (602) 778-3459
- Fax: (562) 308-3699
Contact Ethicspoint, an independent organization:
- Phone: 1-877-863-3362
- Electronically: www.ethicspoint.com
Contact OIG:
