Fraud, Waste, and Abuse

Report Fraud, Waste, & Abuse

MHP Healthy Michigan (MHP Healthy Michigan ) is committed to preventing health care fraud, waste, and abuse, as well as complying with applicable state and federal laws governing fraud and abuse.

Examples of fraud & abuse by a member include:

  • Altering or forging a prescription
  • Altering medical records
  • Changing or forging referral forms
  • Allowing someone else to use their MHP Healthy Michigan member ID card to obtain health care services  

Examples of fraud & abuse by a provider include:

  • Falsifying his/her credentials
  • Billing for services not performed
  • Billing more than once for same services
  • Upcoding and unbundling procedure codes
  • Over-utilization, performing inappropriate/unnecessary services
  • Under-utilization, not ordering services that are medically necessary
  • Collusion among providers  

Examples of fraud and abuse by a MHP Healthy Michigan employee include:

  • Altering provider contracts or forging signatures
  • Collusion with providers or members
  • Intentionally denying services or benefits that are normally covered
  • Inappropriate incentive plans for providers
  • Embezzlement or theft  

The Deficit Reduction Act of 2005 requires information about both the federal False Claims Act and other laws associated with:

  • Fraud, Waste, & Abuse
  • Whistleblower Protection

Federal law prohibits an employer from discriminating against an employee in the terms and conditions of his/her employment because the employee initiated or otherwise assisted in a false claims action. 

To report a possible violation, (you may remain anonymous), in writing to:

McLaren Health Plan
Attn: Compliance Officer
G-3245 Beecher Road, Suite 200
Flint, MI 48532

Or by calling the MHP Compliance Hotline: (866) 866-2135.

To report Medicaid Fraud, Waste, & Abuse (you may remain anonymous), in writing to:

Michigan Department of Health and Human Services
Office of Inspector General
P.O. Box 30062
Lansing, MI 48909
By telephone at: (855) MI-FRAUD (643-7283)
Online at: