Fraud and abuse
Health care fraud is falsifying health care transactions for financial gain or other benefit. It can be done by a doctor, a business or a member of a health plan. There are many types:
- Billing for services that did not happen
- Services done just to get reimbursed
- Filing claims for services or drugs not received
- Forging or changing bills, receipts or other forms
- Doctor shopping to get more than one prescription
If found guilty of this crime, it could result in prison or major fines. It also increases total health care costs, which means you may have to pay more for benefits.
What are we doing to stop fraud?
HAP Midwest Health Plan uses special software to monitor claims data and other information to show which claims need to be reviewed. has a highly skilled team that seeks out health care fraud. These actions are taken to protect our members.
Please report fraud right away. We look into every report of health care fraud, waste and abuse.
You can send an anonymous report to
HAP Midwest, the Michigan Department of Health and Human Services or the Office of the Inspector General.
HAP Midwest Health Plan
You can call us at (866) 622-8980. Or our Compliance Hotline: 24 hours a day at (877) 746-2501.
To report it in writing, include your contract number, date of service and other information that may be useful. Send to:
P.O. Box 2578
Detroit, MI 48202
Attention: Midwest Information Privacy & Security Office
Michigan Department of Health and Human Services
P.O. Box 30062
Lansing, MI 48909
Please keep this overview of this important information.