According to a House Ways and Means oversight subcommittee, in 2016, Medicare Advantage had an improper payment rate of 10 percent. This amounted to approximately $16 billion. When overpayments for standard Medicare are added, the total amount for overpayment is almost $60 billion.1
As part of our efforts to improve the healthcare system, Humana has made a commitment to detecting, correcting and preventing fraud, waste and abuse.
Success in this effort is essential to maintaining a healthcare system that is affordable for everyone. Humana has an ongoing nationwide campaign to get the word out about how contracted physicians, other healthcare providers and business partners can help with fraud, waste and abuse detection, correction and prevention.
If you suspect fraud, waste or abuse in the healthcare system, you must report it to Humana and we’ll investigate. Your actions may help improve the healthcare system and reduce costs for everyone.
To report suspected fraud, waste or abuse, you can contact Humana in one of these ways:
You have the option for your report to remain anonymous. All information received or discovered by the Special Investigations Unit (SIU) will be treated as confidential, and the results of investigations will be discussed only with persons having a legitimate reason to receive the information (e.g., state and federal authorities, Humana corporate law department, market medical directors or Humana senior management).
To learn more about Humana’s fraud, waste and abuse prevention efforts, visit Humana.com/fraud.