Healthcare Fraud Reporting

Updated as of May 8th, 2024
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What is Healthcare Fraud?

Fraud is knowingly submitting, or causing to be submitted, false claims or making misrepresentations of fact to get a federal health care payment when no entitlement would otherwise exist. Knowingly soliciting, getting, offering, or paying remuneration (for example, kickbacks, bribes, or rebates) to induce or reward referrals for items or services reimbursed by federal health care programs. Making prohibited referrals for certain designated health services is another example. Fraud requires intent to get payment and knowledge the actions are wrong.

What is Waste & Abuse?

Waste describes practices that, directly or indirectly, result in unnecessary Medicare Program costs, like overusing services. Waste is generally not considered to be criminally negligent but rather the misuse of Resources. Abuse describes practices that, directly or indirectly, result in unnecessary Medicare Program costs. Abuse includes any practice that doesn’t provide patients with medically necessary services or meet professionally recognized standards of care.

How to Report an Issue

Aloe Care and its customers have an obligation to report compliance issues and assist in any related investigation or corrective action. Aloe Care members, employees, Directors, and contractors may report compliance issues directly to the Medicare Compliance Officer by phone at 1-480-726-3427 or by email to complianceofficer@getaloecare.com or medicarecompliance@getaloecare.com.
Aloe Care members, employees, Directors, contractors, downstream entities, and other parties may also report suspected compliance violations anonymously at 1-888-890-3959.

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