FRAUD AND ABUSE

The Department of Public Welfare (DPW) has established a hotline to report suspected fraud and abuse committed by any entity providing services to Medical Assistance recipients. The hotline number is 1-866-DPW-TIPS (1-866-379-8477) and operates between the hours of 8:30 AM and 3:30 PM, Monday through Friday. Voice mail is available at all other times. Callers may remain anonymous and may call after hours and leave a voice mail if they prefer.

Some common examples of fraud and abuse are:

• Billing or charging Medical Assistance recipients for covered services
• Billing more than once for the same service
• Dispensing generic drugs and billing for brand name drugs
• Falsifying records
• Performing inappropriate or unnecessary services

Suspected fraud and abuse may also be reported via the website at: www.dpw.state.pa.us/dpworganization/officeofmedicalassistanceprograms/
bureauofprogramintegrity/S_002329 or emailed to omaptips@state.pa.us. Information reported via the website or email can also be done anonymously. The website contains additional information on reporting fraud and abuse.

Mandatory Training
All new providers to VBH-PA are required to complete the New Provider Trainings. VBH-PA requires that all new providers complete the fraud, waste and abuse training available on the vbh-pa.com internet website upon the completion of the credentialing process. The address is as follows:
www.vbh-pa.com/fraud_abuse.htm.