A Healthy CollaborationSM

Medicare Fraud, Waste and Abuse

Insurance fraud affects everyone by making insurance premiums more expensive. Community CCRxSM is helping the fight against health care fraud by increasing awareness among our members and employees.

We fully support the prosecution of health care providers, agents, policy owners, employees, and other groups or individuals who defraud the Medicare system and insurance companies. We aggressively investigate reports of fraud and cooperate with law enforcement officials in their prosecution efforts.

Examples of Medicare Plan Fraud:

  • Billing for prescriptions that were not dispensed
  • Dispensing a generic drug, but billing for a brand name drug
  • Prescription drug shorting (i.e., billing for 60 tablets, but dispensing 30)
  • Bait and switch pricing
  • Routine waivers of co-insurance premiums
  • Charging a beneficiary a price over the co-pay amount
  • Adding unauthorized refills to a prescriptions
  • Drug diversion
  • Prescription forging or altering
  • Patient has falsely assumed someone‚Äôs identity in an attempt to utilize their Medicare benefits

Help Fight Fraud

When someone commits fraud against Medicare, it affects everyone. If you suspect someone of committing insurance fraud against Community CCRx or think you may be a victim, please report the suspicious activity.

Fraud, Waste and Abuse can be reported by telephone at 1-866-684-5353 or in writing to:

Community CCRx FWA
Unit P.O. Box 5205
Rensselaer, NY 12144-5205

All reports are confidential and may be anonymous.

For more information about insurance fraud, visit www.insurancefraud.org.

S5803_09P0008_v2 (07/2009) Last Updated: 06/23/2009

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