Help Us Stop Member Fraud and Abuse
PHP FamilyCare has started a program to help stop member fraud and abuse.  

What is Fraud and Abuse?
Fraud is when someone lies or doesn’t tell the truth and then they benefit from it. Examples of Fraud are:  

• Using an expired ID card
   
• A Primary Care Provider (PCP) discharging members from their care because of the member’s health
   
• Allowing a friend or family member to use your ID card
   
• Changing a prescription
   
• Trying to get a refill that is not allowed on a prescription
   
• Telling a lie to get medical or pharmacy services
   
• Being billed for services when no services were provided

Abuse is when actions are done that are wasteful and costs the health plan or the Medicaid program extra money. Examples of Abuse are:  

• Going to the Emergency Room for non-emergency medical services
   
• Hostile or rude behavior in a doctor’s office, hospital or pharmacy

Please contact us about any fraud or abuse. You can call us at 517.364.8551 (toll-free (800) 661-8299), or you can send a letter to:  

PHP FamilyCare
PO Box 30377
Lansing, Michigan 48909-7877

You can also contact the Medicaid department directly about any fraud or abuse by calling 1.866.428.0005, or by sending a letter to:  

Medicaid Integrity Program Section (MIPS)
Capitol Commons Center Building
400 South Pine, 6th Floor
Lansing, MI 48909

You don’t have to give us your name and we won’t tell anybody that you called us.