Waste, Abuse and Fraud (WAF) Program  

Peach State Health Plan takes the detection, investigation, and prosecution of waste, fraud, and abuse very seriously.  It operates a WAF program that complies with all state and federal laws.  Peach State’s management company, Centene Corporation, successfully operates a Special Investigations Unit that mines claims data for upcoding, unbundling, and other systematic deviations that suggest fraudulent or abusive billing practices and investigates all reports of waste, fraud, and abuse.  Peach State’s Compliance Department and Centene’s Special Investigations Unit work very closely with the Department of Community Health and the Georgia Medicaid Fraud Control Unit in prosecuting substantiated instances of health care fraud.  

If you suspect or witness health care fraud committed by a provider, member, or employee, please call Peach State’s anonymous and confidential hotline at (866) 685-8664.  

Authority and Responsibility  

Peach State Health Plan is committed to identifying, investigating, and prosecuting those who commit health care fraud.  Peach State’s Vice President of Regulatory Affairs and Compliance has overall responsibility and authority for carrying out the provisions of the compliance and WAF programs.