Report Fraud, Waste and Abuse
Waste, Abuse and Fraud (WAF) Program
CeltiCare Health 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. CeltiCare Health’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. CeltiCare Health’s Compliance Department and Centene’s Special Investigations Unit work very closely with the Department of Community Health and the Massachusetts 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 CeltiCare Health’s anonymous and confidential hotline at (855) 678-6975.
Authority and Responsibility
CeltiCare Health is committed to identifying, investigating, and prosecuting those who commit health care fraud. CeltiCare Health’s Vice President of Regulatory Affairs and Compliance has overall responsibility and authority for carrying out the provisions of the compliance and WAF programs.